DOI: 10.36347/sjams.2021.v09i06.034

Pages: 1035-1040

Introduction: Childhood HSP is a systemic vasculitis of diverse clinical features with a favorable prognosis but renal involvement in HSP can cause chronic kidney disease (CKD) in children which is preventable in most cases if diagnosed and referred early. Aim of the study: To determine the occurrence ratio of HSP in children, its clinical behavior, renal involvement, and possible remedies. Methods: Medical records of 31 HSP patients were evaluated in the Nephrology and Rheumatology department of Dhaka Shishu (Children) Hospital from July 2017 to December 2019. Epidemiological data, clinical and laboratory findings were reviewed. The treatment for each patient was recorded including supportive care antihypertensive, ACE inhibitor, and immunosuppressive drug. Result: Most children affected during winter and spring (29%). Mean duration of disease 21.19 ±11.54 days. The mean age was 8.63±2.53 yrs. The mean age of renal involvement was 9.5 years. Male-female ratio 5.7:2. Almost all children (96.8%) presented with a rash. Abdominal pain was noted in 74.19% of patients. Joint pain was reported in 51.6% of patients. Renal involvement was presented in 58% of patients commonly in the form of proteinuria (58.6%) and hematuria (48.4%). 9 (29%) patients developed acute kidney injury (AKI). Occasional complications include convulsion, intestinal obstruction, septicemia, and pneumonia. Lab analysis showed thrombocytosis in 54% of patients, leukocytosis in 61% of patients, hypo-albuminemia in 58% of patients. C3 low in 29% patients. A kidney biopsy was done in 10 patients. IgA deposition and mesangial cell proliferation were the most common pathology. Regarding treatment, 12 patients were treated with methylprednisolone and MMF. 8 patients go into remission after taking only oral prednisolone. 6 patients took ACE inhibitor and 2 patients need dialysis. The majority of children (90.3%) achieved remission, though 2 patients died during admission. Conclusion: Present literature .....