Henoch-Schonlein Purpura (HSP)
DOI:
Abstract Views:
2069 times
PDF Downloads:
1963 times
Abstract
Abstract—Henoch-Schonlein purpura (HSP) is a systemic vasculitic disease (vascular inflammation) characterized by the deposition of immune complexes consisting of IgA in kidney skin. This disease is called Anaphylactoid purpura, rheumatic Purpura, Schonlein-Henoch purpura. In this case, the patient complained of the appearance of red spots on the legs to the buttocks within three days and did not feel itchy. Ankle pain and can not be moved, and do not feel nausea, fever, heartburn, and others. Examination of the extremities contained red lesions and was more prominent than other skin surfaces. Diagnosis of patients suspected of having Henoch-Schonlien purpura. Treatment of HSP patients with Prednisone at a dose of 2 mg/kg/day which is divided into three doses. On the third-day purpura decreases tend to thin out and enkle pain disappears on the fifth day. Red spots appear, after therapy is stopped for 1 month. HSP sufferers 94% recover in children and 89% in adults. HSP recuration is more common in children over the age of 10 years and a kidney biopsy must be performed to determine subsequent therapy.
Abstrak—Henoch-Schonlein purpura (HSP) adalah penyakit vaskulitik sistematik (inflamasi vaskuler) ditandai dengan deposisi komplek imun yang terdiri dari IgA pada kulit ginjal. Penyakit ini disebut Anaphylactoid purpura, Purpura rheumatic, Schonlein-Henoch purpura. Pada kasus ini pasien mengeluh timbulnya bercak merah pada kaki sampai bagian pantat dalam waktu tiga hari dan tidak merasa gatal-gatal. Pergelangan kaki nyeri dan tidak bisa digerakkan, serta tidak merasa mual, demam, nyeri ulu hati dan lain-lain. Pemeriksaan ekstremitas terdapat lesi merah dan lebih menonjol dibandingkan premukaan kulit lain. Diagnosa pasien di duga menderita Henoch-Schonlien purpura. Pengobatan pasien HSP dengan Prednison dengan dosis 2mg/kgBB/hari yang terbagi dalam tiga dosis. Pada hari ketiga purpura berkurang cenderung menipis dan nyeri enkle menghilang pada hari kelima. Bercak merah timbul, setelah terapi dihentikan selama 1 bulan. Penderita HSP 94% sembuh pada anak-anak dan 89% pada dewasa. Rekurnasi HSP lebih sering terjadi pada anak usia diatas 10 tahun dan biopsi ginjal harus dilakukan untuk menentukan terapi selanjutnya.
Downloads
References
Frigas E, Park MA. Acute urticaria and angioedema: diagnostic and treatment considerations. Am J Clin Dermatol. 2009. 10(4):239-50
http://www.dermatology.ucsf.edu/education_training/140.01ClinicalDermato
logy/MODULES%20UCSF/Petechia%20Purpura%20Vasculitis.pdfJennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013; 65:1.
Sandler SG, Tutuncuoglu SO. Immune thrombocytopenic purpura - current management practices. Expert Opin Pharmacother. 2004 Dec.
Yang YH, Yu HH, Chiang BL. The diagnosis and classification of Henoch-Schönlein purpura: an updated review. Autoimmun Rev 2014; 13:355.
Dillon MJ. Henoch-Schönlein purpura: recent advances. Clin Exp Rheumatol 2007; 25:S66.
Peru H, Soylemezoglu O, Bakkaloglu SA, et al. Henoch Schonlein purpura in childhood: clinical analysis of 254 cases over a 3-year period. Clin Rheumatol 2008; 27:1087.
McCarthy HJ, Tizard EJ. Clinical practice: Diagnosis and management of Henoch-Schönlein purpura. Eur J Pediatr. 2010 Jun. 169(6):643-50.
Piram M, Mahr A. Epidemiology of immunoglobulin A vasculitis (Henoch-Schönlein): current state of knowledge. Curr Opin Rheumatol 2013; 25:171.
Chang WL, Yang YH, Lin YT, Chiang BL. Gastrointestinal manifestations in Henoch-Schönlein purpura: a review of 261 patients. Acta Paediatr 2004; 93:1427.
Nathan K, Gunasekaran TS, Berman JH. Recurrent gastrointestinal Henoch-Schönlein purpura. J Clin Gastroenterol 1999; 29:86.
Yu JE, Mancini AJ, Miller ML. Intussusception in an infant with acute hemorrhagic edema of infancy. Pediatr Dermatol 2007; 24:61.
Watanabe T, Sato Y. Renal involvement and hypocomplementemia in a patient with acute hemorrhagic edema of infancy. Pediatr Nephrol 2007; 22:1979.
Ghrahani R, Ledika MA, Sapartini G, Setiabudiawan B. Age of onset as a risk factor of renal involvement in Henoch-Schönlein purpura. Asia Pac Allergy 2014; 4:42.
Nadrous HF, Yu AC, Specks U, Ryu JH. Pulmonary involvement in Henoch-Schönlein purpura. Mayo Clin Proc 2004; 79:1151.
Vats KR, Vats A, Kim Y, et al. Henoch-Schönlein purpura and pulmonary hemorrhage: a report and literature review. Pediatr Nephrol 1999; 13:530.
Belman AL, Leicher CR, Moshé SL, Mezey AP. Neurologic manifestations of Schoenlein-Henoch purpura: report of three cases and review of the literature. Pediatrics 1985; 75:687.
Misra AK, Biswas A, Das SK, et al. Henoch-Schonlein purpura with intracerebral haemorrhage. J Assoc Physicians India 2004; 52:833.
Chamberlain RS, Greenberg LW. Scrotal involvement in Henoch-Schönlein purpura: a case report and review of the literature. Pediatr Emerg Care 1992; 8:213.
Ha TS, Lee JS. Scrotal involvement in childhood Henoch-Schönlein purpura. Acta Paediatr 2007; 96:552.
Cheung KM, Mok F, Lam P, Chan KH. Pancreatitis associated with Henoch-Schonlein purpura. J Paediatr Child Health 2001; 37:311.
Mills JA, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Henoch-Schönlein purpura. Arthritis Rheum 1990; 33:1114.
Ozen S, Ruperto N, Dillon MJ, et al. EULAR/PReS endorsed consensus criteria for the classification of childhood vasculitides. Ann Rheum Dis 2006; 65:936.
Ozen S, Pistorio A, Iusan SM, et al. EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis 2010; 69:798.
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
- Articles published in Keluwih: JKK are licensed under a Creative Commons Attribution-ShareAlike 4.0 International license. You are free to copy, transform, or redistribute articles for any lawful purpose in any medium, provided you give appropriate credit to the original author(s) and the journal, link to the license, indicate if changes were made, and redistribute any derivative work under the same license.
- Copyright on articles is retained by the respective author(s), without restrictions. A non-exclusive license is granted to Kluwih: JKK to publish the article and identify itself as its original publisher, along with the commercial right to include the article in a hardcopy issue for sale to libraries and individuals.
- By publishing in Keluwih: JKK, authors grant any third party the right to use their article to the extent provided by the Creative Commons Attribution-ShareAlike 4.0 International license.
