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Add‐on therapy with montelukast in the treatment of H enoch– S chönlein purpura
Author(s) -
Wu ShengHua,
Liao PeiYuan,
Chen XiaoQing,
Yin PeiLing,
Dong Ling
Publication year - 2014
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/ped.12271
Subject(s) - medicine , montelukast , henoch schonlein purpura , gastroenterology , leukotriene receptor , eosinophil , proteinuria , placebo , eosinophil cationic protein , immunology , nephropathy , lupus nephritis , leukotriene e4 , asthma , leukotriene , endocrinology , disease , pathology , vasculitis , kidney , alternative medicine , diabetes mellitus
Background Previous studies suggested that leukotrienes ( LT ) were involved in the pathogenesis of H enoch– S chönlein purpura ( HSP ). This study investigated the efficacy of an add‐on therapy with montelukast in the treatment of HSP . Methods In this four‐center, double‐blind, placebo‐controlled, parallel paired comparative study, 130 children with HSP were divided into two large groups: 84 patients without nephritis and 46 patients with nephritis. For each pair of patients with the same severity of disease, one subject was randomly allocated to one subgroup and the other allocated to the other subbroup; one subgroup received routine treatment plus placebo treatment, while the other subgroup received routine treatment plus montelukast treatment for 3 months. The efficacy was determined using Severity Scale Score ( SSS ). Blood eosinophil count, eosinophil cationic protein ( ECP ), IgE , interleukin ( IL )‐4, IL ‐5, IL ‐6, IL ‐8, IL ‐17, LTB 4 , and urinary LTE 4 were measured. Results Add‐on therapy with montelukast alleviated the symptoms of HSP including purpura, abdominal pain, stool occult blood, arthritis, proteinuria and hematuria, and, accordingly, shortened the length of hospital stay, and lowered blood eosinophil count, ECP , IgE , IL ‐4, IL ‐5, IL ‐6, IL ‐8, IL ‐17, LTB 4 , and urinary LTE 4 production, and also lowered the HSP relapse rate during the 3 months of treatment, but did not alter the outcome of nephritis at the end of follow up. Conclusions Add‐on therapy with montelukast alleviated the symptoms of HSP . HSP may be improved by add‐on therapy with a leukotriene receptor antagonist.