Anaphylactoid purpura is a generalized vasculitis characterized by cutaneous purpura, arthritis, abdominal pain, gastrointestinal bleeding and nephritis. This study was performed to analyze clinical symptoms and to determine whether
corticosteroid
therapy was effective in preventing delayed nephritis in children with anaphylactoid purpura.
Clinical manifestations and laboratory findings were reviewed by medical by medical records in 62 cases with anaphylactoid purpura hospitalized at Chung-Ang University Hospital during the period between March, 1985 and February, 1994.
@ES The following results were obtained.
@EN 1) The age distribution of anaphylactoid purpura showed a peak incidence between 4 to 6 years of age and male preponderance was observed (male to female ratio=1.3 : 1).
2) In seasonal incidence, the cases were frequent during Autumn(34%) and Spring(29%)
3) No specific history was noted in 33 cases(53%), previous history of upper respiratory infection was noted in 23 cases(37%) and only 6 cases(10%) showed gastroenteritis.
4) The clinical manifestations showed in skin(100%), gastrointestinal tract(81%), joint(79%), kidney (34%) respectively.
5) As for the gastrointestinal symptoms, abdominal pain was observed in all cases and others were occult blood(50%), and nausea and vomiting(38%.
6) The joint swelling was observed mostly on knee joint(80%), and ankle joint(61%).
7) Hematologically, mild anemia was observed in 29% of cases, leukocytosis in 61% of cases, increased platelet count in 52% of cases, increased ESR in 58% of cases. Positive anti-streptolysin 0 titer was observed in 39% of cases and positive
C-reactive
protein in 67% of cases. In coagulation studies were within normal ranges.
8) Skin, abdominal and joint manifestation was recovered within 1 month. As to the 21 case with renal involvement, 4 cases(19%) normalized within 1 month, and at least 11 cases(52%) showed persistent abnormal finding in urinalysis over 1 month
after
initial presentations.
9) Delayed nephritis developed in 7 of 35(20%) patients who received prior treatment with corticosteroids and in 3 of 16(19%) patients who were not treated. Thus, prior corticosteroids therapy had no effect on the frequency of delayed nephritis.
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