Corticosteroids Improve Outcomes During Hospitalization for Henoch-Schönlein Purpura (HSP)

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A retrospective cohort study included children discharged with an ICD code of Henoch-Schönlein purpura (HSP) between 2000 and 2007 from 36 tertiary care children's hospitals.

During the 8-year study period, there were 1895 hospitalizations for new-onset HSP. Early corticosteroid exposure significantly reduced the hazard ratios for abdominal surgery (0.39), endoscopy (0.27), and abdominal imaging (0.50).

In the hospital setting, early corticosteroid exposure was associated with benefits for several clinically relevant HSP outcomes, specifically those related to the gastrointestinal manifestations of the disease.

The increased frequency of peripheral Th17 cells and serum IL-17 levels are shown in childhood HSP that may in part contribute to vascular inflammation, suggesting cellular immunity is likely to be involved in the process of HSP (Ped Allergy Immunology, 2011).

Henoch - Schönlein Purpura (HSP) Mnemonic

HSP = 10 P

PALPABLE
PURPURA
PLATELETS OK -- DDx from ITP
PRURITUS -- URTICARIA
PAIN -- ABDOMEN and LEGS
POSITIVE +guaiac -- FECES
PRESSURE -- increased blood pressure
PROTEINURIA
PREDNISONE = Tx

References:

Corticosteroids May Improve Clinical Outcomes During Hospitalization for Henoch-Schönlein Purpura. PEDIATRICS Vol. 126 No. 4 October 2010, pp. 674-681 (doi:10.1542/peds.2009-3348).

Henoch-Schönlein Purpura - JAMA Patient Page http://goo.gl/e05qx