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Predictive Factors of Organ Involvement in Childhood Henoch-Schonlein Purpura [J Dr Behcet Uz Child Hosp]
J Dr Behcet Uz Child Hosp. 2022; 12(2): 120-127 | DOI: 10.4274/buchd.galenos.2022.87533  

Predictive Factors of Organ Involvement in Childhood Henoch-Schonlein Purpura

Esra Nagehan Akyol Önder, Pelin Ertan
Manisa Celal Bayar University Faculty of Medicine, Department of Pediatric Nephrology, Manisa, Turkey

Objective: Henoch-Schonlein purpura (HSP) is the most common vasculitis of childhood, presenting with immunoglobulin A-dominant immune deposits. Unless there is an organ involvement, the prognosis of HSP is excellent. In this study, we aimed to evaluate clinical and laboratory risk factors for organ involvement in patients with HSP.
Method: Our study sample consisted of 95 children with HSP and 75 healthy controls. Clinical and laboratory parameters recorded at the first admission to the hospital were retrospectively evaluated. The neutrophil-tolymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated based on the complete blood counts.
Results: Leucocyte, neutrophil and lymphocyte counts, C-reactive protein, PLR, platelet distribution width, and NLR were significantly higher in the HSP group than in the control group (p=0.008, p<0.001, p=0.003, p<0.001, p=0.002, p<0.001, p=0.002, and p<0.001, respectively). In the HSP group, NLR, PLR and lymphocyte were significantly higher among the patients with renal involvement and those with gastrointestinal involvement. Neutrophil levels were correlated with renal involvement. Additionally, the older age onset of the disease and elevated antistreptolysin O (ASO) levels were associated with renal involvement.
Conclusion: NLR, PLR and lymphocyte counts may be used as inflammatory indicators of renal and gastrointestinal involvement in HSP. In addition, the neutrophil count is associated with renal involvement. The older age onset of HSP and elevated ASO levels are risk factors for renal involvement in HSP.

Keywords: Child, gastrointestinal involvement, Henoch-Schonlein purpura, renal involvement


Henoch-Schönlein Purpuralı Çocuklarda Organ Tutulumunu Belirleyen Faktörler

Esra Nagehan Akyol Önder, Pelin Ertan
Manisa Celal Bayar Üni̇versi̇tesi̇ Tıp Fakültesi̇, Çocuk Nefrolojisi Bilim Dalı

Amaç: Henoch-Schönlein purpurası (HSP) çocukluk çağının en sık görülen vaskülitidir ve immünoglobulin A’nın baskın olduğu immün birikintilerle kendini gösterir. Organ tutulumu olmadıkça HSP’nin prognozu mükemmeldir. Bu çalışmada HSP’li hastalarda organ tutulumu için klinik ve laboratuvar risk faktörlerini değerlendirmeyi amaçladık.
Yöntem: Çalışma örneklemi HSP’li 95 çocuk ve 75 sağlıklı kontrolden oluştu. Hastaneye ilk başvuruda kaydedilen klinik ve laboratuvar parametreleri geriye dönük olarak değerlendirildi. Nötrofil-lenfosit oranı (NLR) ve trombositlenfosit oranı (PLR), tam kan sayımlarına göre hesaplandı.
Bulgular: Lökosit, nötrofil ve lenfosit sayıları, C-reaktif protein, PLR, trombosit dağılım genişliği ve NLR, HSP grubunda kontrol grubuna göre anlamlı olarak daha yüksekti (p=0,008, p<0,001, p=0,003, p<0,001, p=0,002, p<0,001, p=0,002 ve p<0,001, sırasıyla). HSP grubunda böbrek ve gastrointestinal tutulumu olan hastalarda NLR, PLR ve lenfosit anlamlı olarak daha yüksekti. Nötrofil seviyeleri böbrek tutulumu ile korele idi. Ek olarak, hastalığın ileri yaşta başlaması ve yüksek antistreptolizin O (ASO) seviyeleri böbrek tutulumu ile ilişkiliydi.
Sonuç: NLR, PLR ve lenfosit sayıları, HSP’de renal ve gastrointestinal tutulumun enflamatuvar göstergeleri olarak kullanılabilir. Ek olarak, nötrofil sayısı böbrek tutulumu ile ilişkilidir. HSP’nin daha ileri yaşta başlaması ve yüksek ASO seviyeleri, HSP’de böbrek tutulumu için risk faktörleridir.

Anahtar Kelimeler: Çocuk, gastrointestinal tutulum, Henoch-Schonlein purpurası, böbrek tutulumu


Esra Nagehan Akyol Önder, Pelin Ertan. Predictive Factors of Organ Involvement in Childhood Henoch-Schonlein Purpura. J Dr Behcet Uz Child Hosp. 2022; 12(2): 120-127

Corresponding Author: Esra Nagehan Akyol Önder, Türkiye


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