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07.01.2022 | Original Article

Analysis of children with Henoch–Schonlein purpura secondary to infection

verfasst von: Can Liu, Lingli Luo, Min Fu, Zhengqiu Li, Jianlong Liu

Erschienen in: Clinical Rheumatology | Ausgabe 3/2022

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Abstract

Objectives

Henoch–Schonlein purpura (HSP) is the most common childhood vasculitis, infection is the most essential inducement. We hypothesized that infection could impact the blood routine characteristics and/or outcome of vasculitis. Thus, we aim to find the most common infectious agent in HSP patients and identify convenient indicators to predict renal involvement in HSP patients with infection.

Method

We conducted a retrospective study of 208 HSP children and 98 healthy children. Clinical parameters were compared in those cases.

Results

A total of 68.75% of patients were infected with various pathogens. The mean platelet volume (MPV) (P < 0.02) was lower in HSP patients with infection than patients without infection. Mycoplasma pneumoniae (MP) infection accounted for the largest proportion (45.77%). MPV in HSP nephritis (HSPN) group was lower than in HSP patients (excluded renal involvement) in patients with MP infection. Logistic regression analysis found that age and MPV were risk factors for the occurrence of MP-infected HSPN. The receiver operating characteristic curve (ROC) analysis showed that the combination of MPV with the onset age at the optimal cut-off point had 81% sensitivity in predicting whether HSP patients with MP infection would develop into HSPN.

Conclusions

Our research revealed that MP was the most commonly infected pathogen of children’s HSP. MPV was an essential predictor of nephritis in HSP patients with MP infection. This discovery can prompt clinical treatments as well as reduce costs.
Key Points
• Mycoplasma pneumoniae (MP) accounts for the largest proportion in HSP children with infection.
• MPV can be used as a predictor for the development of MP-triggered HSP to HSPN.
Literatur
1.
Zurück zum Zitat Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, Flores-Suarez LF, Gross WL, Guillevin L, Hagen EC, Hoffman GS, Jayne DR, Kallenberg CG, Lamprecht P, Langford CA, Luqmani RA, Mahr AD, Matteson EL, Merkel PA, Ozen S, Pusey CD, Rasmussen N, Rees AJ, Scott DG, Specks U, Stone JH, Takahashi K, Watts RA (2013) 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 65(1):1–11. https://doi.org/10.1002/art.37715CrossRefPubMed Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, Flores-Suarez LF, Gross WL, Guillevin L, Hagen EC, Hoffman GS, Jayne DR, Kallenberg CG, Lamprecht P, Langford CA, Luqmani RA, Mahr AD, Matteson EL, Merkel PA, Ozen S, Pusey CD, Rasmussen N, Rees AJ, Scott DG, Specks U, Stone JH, Takahashi K, Watts RA (2013) 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 65(1):1–11. https://​doi.​org/​10.​1002/​art.​37715CrossRefPubMed
2.
Zurück zum Zitat Ruperto N, Ozen S, Pistorio A, Dolezalova P, Brogan P, Cabral DA, Cuttica R, Khubchandani R, Lovell DJ, O'Neil KM, Quartier P, Ravelli A, Iusan SM, Filocamo G, Magalhães CS, Unsal E, Oliveira S, Bracaglia C, Bagga A, Stanevicha V, Manzoni SM, Pratsidou P, Lepore L, Espada G, Kone-Paut I, Zulian F, Barone P, Bircan Z, Maldonado Mdel R, Russo R, Vilca I, Tullus K, Cimaz R, Horneff G, Anton J, Garay S, Nielsen S, Barbano G and Martini A (2010) EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part I: overall methodology and clinical characterisation. Ann Rheum Dis 69(5): p. 790–7. https://doi.org/10.1136/ard.2009.116624 Ruperto N, Ozen S, Pistorio A, Dolezalova P, Brogan P, Cabral DA, Cuttica R, Khubchandani R, Lovell DJ, O'Neil KM, Quartier P, Ravelli A, Iusan SM, Filocamo G, Magalhães CS, Unsal E, Oliveira S, Bracaglia C, Bagga A, Stanevicha V, Manzoni SM, Pratsidou P, Lepore L, Espada G, Kone-Paut I, Zulian F, Barone P, Bircan Z, Maldonado Mdel R, Russo R, Vilca I, Tullus K, Cimaz R, Horneff G, Anton J, Garay S, Nielsen S, Barbano G and Martini A (2010) EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part I: overall methodology and clinical characterisation. Ann Rheum Dis 69(5): p. 790–7. https://​doi.​org/​10.​1136/​ard.​2009.​116624
3.
11.
Zurück zum Zitat Karadağ ŞG, Çakmak F, Çil B, Tanatar A, Sönmez HE, Kıyak A, Yavuz S, Çakan M, and Aktay Ayaz N (2021) The relevance of practical laboratory markers in predicting gastrointestinal and renal involvement in children with Henoch-Schönlein Purpura. Postgrad Med 133(3): p. 272–277. https://doi.org/10.1080/00325481.2020.1807161 Karadağ ŞG, Çakmak F, Çil B, Tanatar A, Sönmez HE, Kıyak A, Yavuz S, Çakan M, and Aktay Ayaz N (2021) The relevance of practical laboratory markers in predicting gastrointestinal and renal involvement in children with Henoch-Schönlein Purpura. Postgrad Med 133(3): p. 272–277. https://​doi.​org/​10.​1080/​00325481.​2020.​1807161
12.
Zurück zum Zitat Yakut HI, Kurt T, Uncu N, Semsa Cayci F, and Celikel Acar B (2020) Predictive role of neutrophil to lymphocyte ratio and mean platelet volume in Henoch-Schönlein purpura related gastrointestinal and renal involvement. Arch Argent Pediatr 118(2):139–142. https://doi.org/10.5546/aap.2020.eng.139 Yakut HI, Kurt T, Uncu N, Semsa Cayci F, and Celikel Acar B (2020) Predictive role of neutrophil to lymphocyte ratio and mean platelet volume in Henoch-Schönlein purpura related gastrointestinal and renal involvement. Arch Argent Pediatr 118(2):139–142. https://​doi.​org/​10.​5546/​aap.​2020.​eng.​139
18.
Zurück zum Zitat Jaszczura M, Góra A, Grzywna-Rozenek E, Barć-Czarnecka M, Machura E (2019) Analysis of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and mean platelet volume to platelet count ratio in children with acute stage of immunoglobulin A vasculitis and assessment of their suitability for predicting the course of the disease. Rheumatol Int 39(5):869–878. https://doi.org/10.1007/s00296-019-04274-zCrossRefPubMed Jaszczura M, Góra A, Grzywna-Rozenek E, Barć-Czarnecka M, Machura E (2019) Analysis of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and mean platelet volume to platelet count ratio in children with acute stage of immunoglobulin A vasculitis and assessment of their suitability for predicting the course of the disease. Rheumatol Int 39(5):869–878. https://​doi.​org/​10.​1007/​s00296-019-04274-zCrossRefPubMed
19.
Zurück zum Zitat Gayret OB, Erol M, and Tekin Nacaroglu H (2016) The relationship of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio with gastrointestinal bleeding in Henoch-Schonlein purpura. Iran J Pediatr 26(5): p. e8191. https://doi.org/10.5812/ijp.8191 Gayret OB, Erol M, and Tekin Nacaroglu H (2016) The relationship of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio with gastrointestinal bleeding in Henoch-Schonlein purpura. Iran J Pediatr 26(5): p. e8191. https://​doi.​org/​10.​5812/​ijp.​8191
26.
Zurück zum Zitat Bitton A, Peppercorn MA (1995) Emergencies in inflammatory bowel disease. Crit Care Clin 11(2):513–529CrossRef Bitton A, Peppercorn MA (1995) Emergencies in inflammatory bowel disease. Crit Care Clin 11(2):513–529CrossRef
29.
Zurück zum Zitat Özel A, Bostan Gayret Ö, Erol M, Yiğit Ö, and Mete F (2018) Are mean platelet volume and neutrophil-to-lymphocyte ratio valuable in the early detection of system involvements in Henoch-Schönlein purpura? Med Bull Haseki 56(4): p. 279–285. https://doi.org/10.4274/haseki.4164 Özel A, Bostan Gayret Ö, Erol M, Yiğit Ö, and Mete F (2018) Are mean platelet volume and neutrophil-to-lymphocyte ratio valuable in the early detection of system involvements in Henoch-Schönlein purpura? Med Bull Haseki 56(4): p. 279–285. https://​doi.​org/​10.​4274/​haseki.​4164
31.
Zurück zum Zitat Douda T, Bures J, Rejchrt S, Kopácová M, Pecka M, Malý J (2006) Mean platelet volume (MPV) in Crohn’s disease patients. Cas Lek Cesk 145(11):870–873PubMed Douda T, Bures J, Rejchrt S, Kopácová M, Pecka M, Malý J (2006) Mean platelet volume (MPV) in Crohn’s disease patients. Cas Lek Cesk 145(11):870–873PubMed
37.
Zurück zum Zitat Liu LJ, Yu J, Li YN (2015) Clinical characteristics of Henoch-Schönlein purpura in children. Zhongguo Dang Dai Er Ke Za Zhi 17(10):1079–1083PubMed Liu LJ, Yu J, Li YN (2015) Clinical characteristics of Henoch-Schönlein purpura in children. Zhongguo Dang Dai Er Ke Za Zhi 17(10):1079–1083PubMed
45.
Zurück zum Zitat Gonzalez-Gay MA, Calviño MC, Vazquez-Lopez ME, Garcia-Porrua C, Fernandez-Iglesias JL, Dierssen T, Llorca J (2004) Implications of upper respiratory tract infections and drugs in the clinical spectrum of Henoch-Schönlein purpura in children. Clin Exp Rheumatol 22(6):781–784PubMed Gonzalez-Gay MA, Calviño MC, Vazquez-Lopez ME, Garcia-Porrua C, Fernandez-Iglesias JL, Dierssen T, Llorca J (2004) Implications of upper respiratory tract infections and drugs in the clinical spectrum of Henoch-Schönlein purpura in children. Clin Exp Rheumatol 22(6):781–784PubMed
Metadaten
Titel
Analysis of children with Henoch–Schonlein purpura secondary to infection
verfasst von
Can Liu
Lingli Luo
Min Fu
Zhengqiu Li
Jianlong Liu
Publikationsdatum
07.01.2022
Verlag
Springer International Publishing
Erschienen in
Clinical Rheumatology / Ausgabe 3/2022
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-021-06007-9

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