Henoch-Schonlein purpura in children from the eastern province of Saudi Arabia

OBJECTIVE: To evaluate the epidemiological and clinical profile of children with Henoch-Schonlein purpura (HSP) in eastern Saudi Arabia during a 15-year period.

METHODS: The medical records of children discharged with a diagnosis of HSP from King Fahad Hospital of the University, Al-Khobar, Saudi Arabia, between January 1996, and December 2010, were reviewed retrospectively.

RESULTS: Of 78 patients, 46 (59%) were boys, with a male to female ratio of 1.4:1. The patients' ages ranged from 22 months to 12 years, with a mean of 6.3 years. Approximately 60% of cases were presented during autumn and winter. Upper respiratory tract infection preceded HSP in over half of the patients and antistreptolyzin O (ASO) titer was positive in 11 of the 24 (46%) children tested at presentation. The main clinical features included skin purpura (100%), arthritis or arthralgia (66%), gastrointestinal manifestation (47%), orchitis (15%) of boys, and nephritis (24%). One patient with severe nephritis developed pulmonary hemorrhage and acute respiratory distress syndrome. Eleven (14%) patients received corticosteroid therapy. All children made a full recovery, only one patient with nephritis continued to have hypertension at 2 years follow up. Symptoms recurred in 6 (7.7%) patients over a period ranging from one month to 2 years.

CONCLUSION: Henoch-Schonlein purpura is a mild disease in the eastern province of Saudi Arabia and with no significant differences in the epidemic and clinical profile than that reported elsewhere.