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KMID : 0816120110140040359
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Korean Journal of Pediatric Gastroenterolology and Nutrition
2011 Volume.14 No. 4 p.359 ~ p.367
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Comparison of the Clinical Manifestations and Prognosis of Henoch-Schonlein Purpura in Children with and without Abdominal Pain
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Kim Sung-Woo
Yoon Jung-Won
Jeong Su-Jin
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Abstract
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Purpose: We compared the clinical manifestations and prognosis of Henoch-Schonlein Purpura (HSP) in children with and without abdominal pain to investigate the usefulness of endoscopy.
Methods: We retrospectively studied 185 HSP inpatients (group A [with abdominal pain] and group N [without abdominal pain]) who had been admitted to the BundangCHA hospital between 2001 and 2010. We compared clinical manifestations, laboratory findings and endoscopic and ultrasonographic findings.
Results: Of the 185 children, 112 (60.5%) had abdominal pain and 31 (16.8%) presented with abdominal pain before developing cutaneous purpura. Group A patients were older (6.9±3.5 vs. 5.3±3.3 years), had higher rates of positive results for stool occult blood (53.8%, p＜0.001), and had longer hospital stays (5.2±4.2 vs. 3.6±2.5 days) than group N patients. Group A had a higher frequency of renal involvement than group N on admission (p=0.047). Ultrasonography showed small bowel wall thickening in 31 cases (43.7%) and increased Doppler flow in the bowel wall in 22 cases (31%) in Group A. Upper gastrointestinal endoscopy revealed HSP - related lesions in the stomach (25 cases) and duodenum (19 cases). The second portion of the duodenum was a more common lesion site than the duodenal bulb. Ultrasonography showed abnormalities in 13 of 19 patients with duodenal lesions. Recurrence was more common in Group A.
Conclusion: These results suggest that recurrence and renal involvement are more common in HSP patients with abdominal pain. Upper gastrointestinal endoscopy could be a useful diagnostic tool for HSP patients who develop abdominal pain before cutaneous purpura.
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KEYWORD
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Henoch-Schonlein Purpura, Ultrasonography, Endoscopy, Abdominal pain
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