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《Journal of Applied Clinical Pediatrics》 2009-21
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Clinical Analysis of Refractory Henoch-Schonlein Purpura in 25 Children

LUO Jie,ZOU Min,XU Qin-ying,MIN Yue,LI Xiao-zhong(Department of Nephrology,Children's Hospital Affiliated to Soochow University,Suzhou 215003,Jiangsu Province,China)  
Objective To explore the clinical feature of refractory Henoch-Schonlein purpura(HSP)and improve the knowledge of the disease.Methods Retrospective method was used to analyze the clinical and laboratory data of 25 children with refractory HSP,and sum up the onset feature,clinical manifestation,treatment and prognosis.SPSS 12.0 software was used to analyze the data.Results Twenty-five children had various degree of digestive symptoms,17 children(68%)were 4-8 years old.The refractory HSP children had a longer abdominal painful time than controls(P0.01),16 children(64%)with refractory gastrointestinal hemorrhage,2 children combined intussusception,4 children were misdiagnosised as acute appendicitis.The percentages of renal injury(44%)were higher in 25 cases with refractory HSP than controls(8%)(P0.01),The quantitation of 24 h urine protein and urine microprotein which had significant discrepancy compared with controls(Pa0.01).The levels of lymphocyte subtypes including CD3,CD4,CD8 were lower in 25 cases with refractory HSP than those in controls(Pa0.05),CD19 was higher than that in controls(P0.05).All children were improved when combined with immunosuppressor.Conclusions The clinical features of refractory HSP are complicated.It has a long and recurrent course,most children have mixed type HSP and show severe gastrointestinal symptoms and renal injury.Cell-mediated immunity function disturburance.The treatment of cortical hormone has little effect,which need combined with immunosuppressor,positive cure should be helpful for reducing relapse.
【Fund】: 国家自然科学基金项目资助(30271234)
【CateGory Index】: R725.5
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