Comparison of Clinical Outcome According to the Duration of Corticosteroid Therapy in Childhood Henoch-Schönlein Purpura: a Bicentric Study

Lee, Su-Jin; Shin, Jae-Il; Lee, Chong-Guk; Kim, Kee-Hyuck

doi:2008.12.2.170

J Korean Soc Pediatr Nephrol > Volume 12(2); 2008 > Article

J Korean Soc Pediatr Nephrol 2008;12(2): 170-177. doi: https://doi.org/10.3339/jkspn.2008.12.2.170

소아 Henoch-Schönlein purpura에서 스테로이드 치료 기간에 따른 임상적 결과의 비교

이수진, 신재일, 이종국, 김기혁

¹국민건강 보험공단 일산병원 소아과
²연세대학교 의과대학 소아과학교실
³인제대학교 의과대학 일산 백병원 소아과
⁴국민건강 보험공단 일산병원 소아과

Comparison of Clinical Outcome According to the Duration of Corticosteroid Therapy in Childhood Henoch-Schönlein Purpura: a Bicentric Study

Su-Jin Lee, Jae-Il Shin, Chong-Guk Lee, Kee-Hyuck Kim

¹Department of Pediatrics, NHIC Ilsan Hospital
²Department of Pediatrics Yonsei University College of Medicine Severance Children's Hospital
³Department of Pediatrics, Ilsan Paik Hospital, Inje University College of Medicine
⁴Department of Pediatrics, NHIC Ilsan Hospital

ABSTRACT

Purpose : The aim of this study was to evaluate whether the incidence of relapse or nephritis might be influenced by the duration of corticosteroid therapy in children with Henoch-Schönlein purpura(HSP).
Methods : We retrospectively analyzed 186 children with a diagnosis of HSP in two major hospitals in Ilsan, Korea from the years 2000 to 2003. To evaluate whether renal involvement or relapse might be influenced by the duration of corticosteroid therapy in children with HSP, one pediatric nephrologist from hospital A, maintained corticosteroid therapy for at least 2 weeks(Group A, n=94). The other from hospital B used only during the symptomatic period(Group B, n=92).
Results : There were no significant differences in age, sex, body weight, white blood cell count, hemoglobin, hematocrit, platelet count, serum protein and albumin levels between the two groups. The incidence of abdominal pain or arthralgia also did not differ between two groups. However, the duration of steroid therapy was significantly longer in Group A than in Group B and the cumulative dose of prednisolone was also higher in Group A than in Group B. The development of nephritis was more frequent in Group A.
Conclusion : The longer duration of steroid use was not associated with the decreased rate of nephritis. Therefore, corticosteroids should be used carefully in a selected group of HSP children, and be tapered rapidly after control of the acute symptoms.

Key words: Henoch-Schönlein purpura | Corticosteroid | Duration | Nephritis | Relapse