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The profile of adult onset H enoch– S chönlein purpura in an A sian population
Author(s) -
Yong Adeline MeiYen,
Lee ShanXian,
Tay YongKwang
Publication year - 2015
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.12732
Subject(s) - medicine , purpura (gastropod) , henoch schonlein purpura , palpable purpura , nephropathy , gastroenterology , disease , immunology , vasculitis , diabetes mellitus , endocrinology , ecology , biology
Background Henoch‐Schönlein purpura ( HSP ) is less common in adults and has been linked with a more severe clinical syndrome as well as a higher frequency of renal disease and internal malignancy. Renal involvement in adult HSP has been significantly associated with antecedent infections, pyrexia at time of first presentation, and purpura above the waist. We aim to evaluate the frequency of cutaneous and extra‐cutaneous features and identify the predictive factors for renal involvement in Asian adults with HSP . Methods We performed a retrospective study of 48 adult Asian patients diagnosed with HSP based on the European League Against Rheumatism ( EULAR ) criteria at a tertiary hospital in Singapore between January 2000 and December 2011. Results The most common cutaneous manifestations were palpable purpura (73%), papules (31%), and petechiae (27%). Forty‐percent had cutaneous lesions extending above the waist. Fifteen patients (31%) had gastrointestinal symptoms, 21 (44%) had joint involvement, and 27 (56%) had renal disease. Seventy‐percent of patients with pyrexia at presentation experienced renal disease, whereas only 30% without pyrexia had renal involvement ( P = 0.018). Sixty‐six percent of patients with purpura had renal involvement as compared to 31% in those without purpura ( P = 0.049). The frequency of renal involvement in patients with purpura above the waist (52%) was similar to those with purpura below the waist (55%). Conclusions Our study confirms that HSP in adults tends to be more severe with a high incidence of extracutaneous manifestations, especially renal disease. Pyrexia at presentation and the presence of purpura were significant predictive factors for renal involvement.