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KMID : 1161220200630050158
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Clinical and Experimental Pediatrics
2020 Volume.63 No. 5 p.158 ~ p.163
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Treatment of refractory IgA vasculitis with dapsone: a systematic review
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Lee Keum-Hwa
Hong Sung-Hwi
Jun Jin-Hae
Jo Young-Heun
Jo Woo-Gyeong
Choi Da-Yeon
Joo Jeong-Ho
Jung Gu-Hyun
Ahn Sung-Hee
Kronbichler Andreas
Eisenhut Michael
Shin Jae-Il
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Abstract
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IgA vasculitis, formerly known as Henoch-Schonlein purpura, is a systemic IgA-mediated vasculitis of the small vessels commonly seen in children. The natural history of IgA vasculitis is generally self-limiting; however, one-third of patients experience symptom recurrence and a refractory course. This systematic review examined the use of dapsone in refractory IgA vasculitis cases. A literature search of PubMed databases retrieved 13 articles published until June 14, 2018. The most common clinical feature was a palpable rash (100% of patients), followed by joint pain (69.2%). Treatment response within 1?2 days was observed in 6 of 26 patients (23.1%) versus within 3?7 days in 17 patients (65.4%). Relapse after treatment discontinuation was reported in 17 patients (65.4%) but not in 3 patients (11.5 %). Four of the 26 patients (15.4%) reported adverse effects of dapsone including arthralgia (7.7%), rash (7.7%), and dapsone hypersensitivity syndrome (3.8%). Our findings suggest that dapsone may affect refractory IgA vasculitis. Multicenter randomized placebo-controlled trials are necessary to determine the standard dosage of dapsone at initial or tapering of treatment in IgA vasculitis patients and evaluate whether dapsone has a significant benefit versus steroids or other medications.
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KEYWORD
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IgA vasculitis, Henoch-Schonlein purpura, Dapsone, Systematic review
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