Intravenous dexamethasone followed by oral prednisolone versus oral prednisolone in the treatment of childhood Henoch-Schönlein purpura

Jae Il Shin, Su Jin Lee, Jae Seung Lee, Kee Hyuck Kim

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The aim of this study was to evaluate the effectiveness of intravenous corticosteroid therapy when Henoch-Schönlein purpura (HSP) patients are unable to tolerate oral medications due to abdominal pain. We retrospectively analyzed 111 children with a diagnosis of HSP (mean age 6.9 ± 2.3 years, male:female = 54:57) from the years 2000 to 2007. They were divided into two groups: 49 patients received only oral prednisolone (PL group) and 62 patients received oral prednisolone after intravenous dexamethasone (Dexa + PL group). Palpable purpura was seen in all 111 patients (100%), abdominal pain in 55 (50%), and arthralgia in 65 (59%). Dexa + PL group had significantly longer duration of fasting than PL group (0.7 ± 1.2 vs. 0.02 ± 0.1 days, P < 0.01) due to more severe and frequent abdominal pain (68 vs. 27%, P < 0.01). Intravenous dexamethasone resulted in the rapid resolution of abdominal pain or arthralgia in all patients without major complications. However, the development of nephritis (21% in PL group versus 32% in Dexa + PL group, P = 0.098), the number of relapse (4 vs. 11%, P = 0.167), and persistent nephritis at last follow-up (12 vs. 16%, P = 0.563) were not different between the two groups despite more severe symptoms in Dexa + PL group. Intravenous dexamethasone followed by oral prednisolone may be a useful and effective therapeutic strategy in HSP children who cannot tolerate oral medications due to severe abdominal pain.

Original languageEnglish
Pages (from-to)1429-1432
Number of pages4
JournalRheumatology International
Volume31
Issue number11
DOIs
Publication statusPublished - 2011 Nov 1

Fingerprint

Schoenlein-Henoch Purpura
Prednisolone
Abdominal Pain
Dexamethasone
Nephritis
Arthralgia
Therapeutics
Purpura
Fasting
Adrenal Cortex Hormones
Recurrence

All Science Journal Classification (ASJC) codes

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

@article{dc38640fa16044e99a85d366a7bf1f5b,
title = "Intravenous dexamethasone followed by oral prednisolone versus oral prednisolone in the treatment of childhood Henoch-Sch{\"o}nlein purpura",
abstract = "The aim of this study was to evaluate the effectiveness of intravenous corticosteroid therapy when Henoch-Sch{\"o}nlein purpura (HSP) patients are unable to tolerate oral medications due to abdominal pain. We retrospectively analyzed 111 children with a diagnosis of HSP (mean age 6.9 ± 2.3 years, male:female = 54:57) from the years 2000 to 2007. They were divided into two groups: 49 patients received only oral prednisolone (PL group) and 62 patients received oral prednisolone after intravenous dexamethasone (Dexa + PL group). Palpable purpura was seen in all 111 patients (100{\%}), abdominal pain in 55 (50{\%}), and arthralgia in 65 (59{\%}). Dexa + PL group had significantly longer duration of fasting than PL group (0.7 ± 1.2 vs. 0.02 ± 0.1 days, P < 0.01) due to more severe and frequent abdominal pain (68 vs. 27{\%}, P < 0.01). Intravenous dexamethasone resulted in the rapid resolution of abdominal pain or arthralgia in all patients without major complications. However, the development of nephritis (21{\%} in PL group versus 32{\%} in Dexa + PL group, P = 0.098), the number of relapse (4 vs. 11{\%}, P = 0.167), and persistent nephritis at last follow-up (12 vs. 16{\%}, P = 0.563) were not different between the two groups despite more severe symptoms in Dexa + PL group. Intravenous dexamethasone followed by oral prednisolone may be a useful and effective therapeutic strategy in HSP children who cannot tolerate oral medications due to severe abdominal pain.",
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Intravenous dexamethasone followed by oral prednisolone versus oral prednisolone in the treatment of childhood Henoch-Schönlein purpura. / Shin, Jae Il; Lee, Su Jin; Lee, Jae Seung; Kim, Kee Hyuck.

In: Rheumatology International, Vol. 31, No. 11, 01.11.2011, p. 1429-1432.

Research output: Contribution to journalArticle

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