Modern views at the morbidity and course of Henoch-Schönlein purpura in children: a literature review

Abstract

The article presents data on the prevalence, etiology, pathogenesis and clinical features of hemorrhagic vasculitis in children, based on the modern scientific literature. The aim of the study was to establish frequency and features of Henoch-Schönlein purpura course in children over the past decade. Materials and methods. Scientific and metric systems Google Scholar, PubMed, CyberLeninka, Cochrane database for the period of 2015–2019 were searched, using the keywords “hemorrhagic vasculitis”, “IgA-аssociated vasculitis”, “acute respiratory infections”, “bacterial infections”, “etiology and pathogenesis”, “clinics”. The frequency of the disease in the population was also analyzed, according to the data of the initial presentation at the inpatient and polyclinic of the Ivano-Frankivsk Regional Children's Clinical Hospital of the Ivano-Frankivsk Regional Council, for the period between 2015 and 2019 respectively. Conclusion. It was established that hemorrhagic vasculitis is the most common in childhood, and is diagnosed approximately in 50 % of cases. The disease is triggered mostly by the genetic, infectious and non-identified factors. The authours have distinguished such pathogenic links as glycosylation disorders of immunoglobulin A, the accumulation of circulating immune complexes, resulting in specific inflammation and blood clotting disorders with subsequent development of thrombosis. There are following clinical findings for hemorrhagic vasculitis: palpable purpura, diffuse abdominal pain, accumulation of IgA (confirmed by biopsy of any organ); arthritis or arthralgia; kidney damage (hematuria and/or proteinuria). These data need to be clarified, and further clinical, cohort, and prospective studies should be conducted.

Keywords

• children
• hemorrhagic vasculitis
• clinical pathology