• Childhood Kidney Diseases
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• v.11 no.2
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• pp.185-194
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• 2007

Purpose : $Henoch-Sch\ddot{o}nlein$ Purpura(HSP) is a self-limited systemic small vessel vasculitis, however, renal involvement is considered to contribute to the outcome of this disease. Therefore, identifying the renal risk factors in HSP and prevention of renal involvement are important. The aim of this study is to investigate whether early steroid administration in HSP could reduce the rate of renal involvement. Methods : We retrospectively studied two hundred children with HSP. We had administrated steroids orally to resolve of severe abdominal pain, joint and scrotal symptoms. We analyzed the relationship between the steroid therapy to relieve systemic symptoms and the subsequent renal involvement in HSP. Results : There were no significant differences in the incidence and duration of renal involvement according to steroid administration and its duration. In HSP patients with renal manifestations, steroid administration group showed a tendency of hematuria and steroid non-administration group showed a tendency of proteinuria, however, we could not find statistically significant differences in each group. There was no significant difference in the duration of purpura presence according to steroid administration. However, persistent purpura increased the incidence and the duration of renal involvement. Conclusion : Early steroid administration did not reduce the risk of renal involvement, there-fore, steroid could not prevent delayed nephritis in children with HSP On the other side, Persistent Purpura, known to be not related to steroid therapy, was associated with renal involvement. We suggest that early steroid administration could not be useful in preventing the renal involvement in HSP. (J Korean Soc Pediatr Nephrol 2007;11:185-194)

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.9 no.2
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• pp.183-192
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• 2006

Purpose: This study was undertaken to evaluate the factors correlated with the clinical course and outcome in patients of Henoch-Sch${\ddot{o}}$nlein Purpura. Methods: The medical records of 104 children diagnosed with Henoch-Sch${\ddot{o}}$nlein Purpura (HSP) from January 1996 to April 2006 were reviewed retrospectively. The patients were divided into two groups: patients with Gastrointestinal (GI) symptoms and those without GI symptoms. When there were joint, scrotum, and renal symptoms except for skin lesion in whole HSP, those patients were excluded. The history of acute infection, duration of admission, treatment requirement, recurrence of HSP, CBC, stool occult blood test, abdominal ultrasonographic findings and GI endoscopic findings were reviewed. Results: Among 104 patients, patients with GI symptoms included 66 cases (63.5%), those without GI symptoms accounted for 38 cases (36.5%). GI symptoms included: abdominal pain in 57 cases (54.8%), vomiting 21 cases (20.2%), GI bleeding 5 cases (4.8%), nausea 3 cases (2.9%) and diarrhea 3 case (2.9%). Positive GI symptoms and GI mucosal lesions on GI endoscopy had a statistically significant correlation with increased admission duration, treatment requirement, recurrence of HSP, and positive stool occult blood. Six cases with small intestinal wall thickening were noted on abdominal ultrasonography. Six cases of hemorrhagic gastritis and hemorrhagic duodenitis, 3 cases of duodenal ulcer, 3 cases of hemorrhagic gastritis and duodenal ulcer, 2 cases of hemorrhagic duodenitis and colitis, and 1 case of colitis were noted on GI endoscopy. Conclusion: These results suggest that GI endoscopic examination may be helpful for the diagnosis and treatment of children with HSP.

• Tuberculosis and Respiratory Diseases
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• v.65 no.2
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• pp.116-120
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• 2008

Rifampin is one of the first line drugs for treating tuberculosis, but it might be associated with serious adverse effects, including renal failure. We report here on a case of a 57-year-old patient who developed Henoch-$Sh{\ddot{o}}nlein$ purpura during antituberculosis therapy that included rifampin. The patient converted to negative on the AFB smear for tuberculosis two weeks after the initial administration of antituberculosis medication. After treatment for 60 days, this patient was diagnosed with Henoch-$Sh{\ddot{o}}nlein$ purpura by the purpura lesion on the lower legs, the leukocytoclastic vasculitis, the renal impairment and the pathological examination. After stopping rifampin, the skin lesions disappeared in about 10 days and his renal function gradually improved. This case study showed that Henoch-$Sh{\ddot{o}}nlein$ purpura can be caused by rifampin during antituberculosis therapy and we recommend that the use of rifampin should be restrained when clinical symptoms of Henoch-$Sh{\ddot{o}}nlein$ purpura are observed.

• Childhood Kidney Diseases
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• v.10 no.1
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• pp.40-44
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• 2006

[ $Henoch-Sch{\"{o}}nlein$ ] purpura(HSP) is a systemic small vessel vasculitis characterized by cutaneous purpura, arthritis, abdominal pain and nephritis. The characteristic rash of HSP consists of palpable purpura on the buttocks and lower extremities. Bullous lesions often appear in adults with HSP, whereas they are very rare in children with HSP. In this case report, the patient presented with arthralgia and abdominal pain and had hemorrhagic bullae as a prominent manifestation of the disease. The skin biopsy of the patient revealed typical leukocytoclastic vasculitis of dermal vessels and prominent IgA and fibrinogen deposits on capillary walls by direct immunofluorescence. We confirmed the diagnosis of HSP and observed improvement of clinical symptoms and signs within a few days after corticosteroid treatment. We therefore report a case with a review of the literature.

• Pediatric Infection and Vaccine
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• v.14 no.1
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• pp.62-68
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• 2007

Purpose : The cause and pathogenesis of Henoch-Sch$\ddot{o}$nlein purpura (HSP) are unknown, but recently the hypothesis that immunoglobulin A may have an important role in the pathogenesis of HSP is being published and HSP associated with mycoplasma infection has been also reported. The aim of this study is to discover relation between HSP and mycoplsma infection. Methods : From Jan. 2002 to Dec. 2005, we retrospectively evaluated 98 children who were diagnosed as HSP at Ilsan Paik Hospital. 84 patients were not associated with mycoplasma infection (group A) and 14 patients were associated with mycoplasma infection (group B). We compared both groups about clinical features. Results : The ratio of male to female patients in group A and B were 1.21:1 and 1.80:1. The number of patients in group A was most in November and December, and in group B was most in November. All patients had non-thrombocytopenic purpura concentrated on the buttocks and lower extremities and joint involvement was most common on the feet and ankle in both groups. 57 (67.9%) cases in group A and 9 (64.3%) cases in group B complained of abdominal pain. And 21 (25.0%) cases in group A and 5 (35.7%) cases in group B had nephritis. Elevated mycoplasma antibody titer (${\geq}1:320$) or 4 fold-rise were noted in 14 of 98 patients (14.3%). In this study, there was one child with HSP preceded by typical mycoplasma pneumonia (mycoplasma antibody titer 1:1280). Conclusion : In this study, elevated mycoplasma antibody titer (${\geq}1:320$) or 4 fold-rise were noted in 14 of 98 patients and the difference of clinical features between group A and B was not specific. The role of mycoplasma infection in the etiology of HSP may have been implicated, so the association with mycoplasma infection should have to be proved by further controlled studies.

• The Journal of Pediatrics of Korean Medicine
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• v.26 no.3
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• pp.12-19
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• 2012

Objectives The purpose of this study is to report the clinical effects of an oriental medical treatment on the patient with allergic purpura. Methods A 7-year-old female patient, who was suffering from the purpura on her extremities: swelling and arthralgia on her lower extremities, was treated by herb medicine, acupuncture and pediluvium. Results Treated only with oriental medicine, the patient's allergic symptoms were improved. When we checked back on her condition after 2 months later, she did not show any recurrence of the flares, and regained her health. Conclusions This study shows that oriental medical treatments are effective on allergic purpura, but further clinical studies are needed.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.5
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• pp.1303-1306
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• 2007

Idiopathic thrombocytopenic purpura(ITP) is an autoimmune disease which is related to antibodies against platelets. More than 95% of the patients progress into chronic type. Usually, IPT patients suffer form hypodermal bleeding, purpura, decreases in platelet counts. Purpura of legs, nosebleeds and oral ulcer may occur. In this study, herbal medicine, acupuncture and moxibustion in conjunction with cupping were applied to IPT patient based on the oriental medicine principle such as Lihyulyanggangeonbi-tang(理血養肝建脾湯). After the treatment, the patient improved better, and had no more inconvenient symptoms according to the follow-up research. So the result shows the possibility that oriental medical treatment may be applied to the IPT patient clinically.

• The Journal of Pediatrics of Korean Medicine
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• v.27 no.4
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• pp.77-86
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• 2013

Objectives Allergic purpura is frequent disease in children. The purpose of this study is to analyze traditional Chinese medicine treatments of Allergic purpura in children through traditional Chinese medical journal research. Methods 22 studies were selected based on title keyword "Allergic purpura" "Child" published in CAJ (China Academic Journal). The studies were about clinical effect, herbs, injections, treatments, and nursing in Allergic purpura in children. Results & Conclusions There are so many treatments studied on purpura in children based on CAJ. A Single or combination traditional Chinese medicine treatment is effective in Allergic purpura in children. Therefore, we need to study more about Allergic purpura in children and should make more clinical cases about it.

• The Journal of Pediatrics of Korean Medicine
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• v.28 no.4
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• pp.108-117
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• 2014

Objectives The purpose of this study is to report the clinical effects of Korean herbal medicine and Chimsband treatment in patients with allergic purpura. Methods 4-year-old female patients, who were suffering from allergic purpura were treated by Korean herbal medicine (Samul-tang hap Yukmijihwang-tang gami) and Chimsband treatment. Also, photographs were used to check the improvement. Results After treating for 15 days, the patients' allergic purpura were improved by Korean herbal medicine and Chimsband treatment. Conclusions This study showed that Korean medical treatments could be an effective treatment option in treating allergic purpura.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.20 no.3
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• pp.260-267
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• 2007

Background and Objective : Allergic purpura is a generalized vasculitis characterized by cutaneous purpura, art hritis, abdominal pain, gastrointestinal bleeding and nephritis. However, the pathophysiology of the Allergic purpura remains obscure. Treatment at present is symptomatic and supportive. There is few reports on Allergic purpura treated with oriental medical treatment. Methods : We conducted two patients with Allergic purpura seen at Won-Kwang University Ik-San Oriental Medical Hospital. We treated Allergic purpura by a herbal medicine, acupunture, etc. Conclusions : We suggest that the oriental medical treatment and management have an effect with Allergic purpura which means Podoyug in Oriental medicine.