engleski

Epidemiological characteristic of childhood vasulitides: A retrospective study over the last 10 years

Introduction: Vasculitis syndromes comprise a heterogeneous group of disorders sharing the hystopathologic features of inflammation and necrosis in blood vessels, which can lead to tissue damage. Aim: To analyze characteristics of the presenting and cumulative clinical features, laboratory features, treatment modalities, disease activity and outcome of children with vasculitis. Methods: All patients aged from 1 to 18 years and diagnosed during the period 1998-2008 at the Division of Paediatric Rheumatology, University Hospital Centre Zagreb, Croatia, as having vasculitis were enrolled into the study. Results: There were 115 children diagnosed as having vasculitis, 51 girls and 64 boys, with the mean age at disease onset (±SD) 9.08±3.53 years. Henoch-Schonlein purpura (HSP) was present in 104 patients (90, 4%) (44 girls and 60 boys), childhood polyarteritis nodosa (C-PAN) in 5 patients (4, 4%) (5 girls) and Kawasaki disease in 6 patients (5, 2%) (2 girls and 4 boys). There were no patients with Takayasu arteritis, Wegener’s granulomatosis and Behcet disease. All patients with HSP were presented with a skin rash that was in the form of purpura (88 patients (84, 7%) with lower extremities and buttocks purpura and 16 (15, 3%) with generalised purpura). Arthritis was present in 76 patients (73, 1%), renal involvement in 23 patients (22, 2%), gastrointestinal involvement 38 patients (36, 6%) (abdomominal pain in all 38 patients and gastrointestinal bleeding in 13 patients), and scrotal swelling in 4 patients (3, 9%). No relation was found between the severity of skin involvement and involvement of other organs. White cell count, ESR and CRP were mildly elevated. Antistreptolysin O was elevated in 79 patients (76%). Supportive measures of treatment in the form of non-steroidal inflammatory drugs were the mode of treatment in the majority of patients, while patients with renal and gastrointestinal involvement were treated with corticosteroids and/or immunosuppresives. During the follow-up, three patients developed chronic renal failure and one patient developed intestinal perforation. Conclusion: Comparing to American, European and Turkish studies we found a difference in the distribution of childhood vasculitides, while clinical, laboratory features and therapy regimens were similar.

vasculitis; childhood

nije evidentirano