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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Pediatr+Rheumatol+Online+J
2018 ; 16
(1
): 25
Nephropedia Template TP
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Incidence and risk factors for recurrent Henoch-Schönlein purpura in children
from a 16-year nationwide database
#MMPMID29661187
Lei WT
; Tsai PL
; Chu SH
; Kao YH
; Lin CY
; Fang LC
; Shyur SD
; Lin YW
; Wu SI
Pediatr Rheumatol Online J
2018[Apr]; 16
(1
): 25
PMID29661187
show ga
BACKGROUND: The recurrence rate of Henoch-Schönlein purpura (HSP) is 2.7%-30%,
with varied average intervals between the first and second episodes. Few studies
have explored the incidence and risk factors for recurrent HSP. METHODS: We used
a 16-year nationwide database to analyze the incidence of recurrent HSP. Patients
with HSP were identified, and risk factors for recurrent HSP were explored.
Kaplan-Meier and Cox regression model analyses were performed, and covariates
were adjusted in the multivariate model. RESULTS: From January 1, 1997 to
December 31, 2012, among 2,886,836 individuals in the National Health Insurance
Research Database, 1002 HSP patients aged 18 years were identified. Among them,
164 had ?2 HSP episodes (recurrence rate, 16.4%; incidence of recurrent HSP, 7.05
per 100 person-years); 83.6% patients with one HSP episode remained free of
secondary HSP. The average time intervals between the first and second and second
and third HSP episodes were 9.2 and 6.4 months, respectively. After adjusting for
demographic parameters, comorbidities, and socioeconomic status, recurrent HSP
was found to occur more frequently in patients who had renal involvement
(adjusted hazard ratio, 2.41; 95% confidence interval [CI], 1.64-3.54;
p?0.001), were receiving steroid therapy for >?10 days (adjusted hazard ratio,
8.13; 95%CI, 2.51-26.36; p?0.001), and had allergic rhinitis (adjusted hazard
ratio, 1.63; 95%CI, 1.06-2.50; p?=?0.026). CONCLUSIONS: The annual incidence of
recurrent HSP was low. However, children who had underlying allergic rhinitis,
presented with renal involvement, and received steroid treatment for >?10 days
should be notified regarding the possibility of recurrence.