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

Rheumatology International volume 31, pages 1429–1432 (2011)Cite this article

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.

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Acknowledgments

This study was supported by Research Grant from the NHIC Ilsan Hospital and was poster presented in the 41st Annual Meeting of the American Society of Nephrology, Renal Week; November 4–9, 2008 in Philadelphia, USA.

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Affiliations

  1. Department of Paediatrics, Yonsei University College of Medicine, Severance Children’s Hospital, Seoul, Korea

    Jae Il Shin & Jae Seung Lee

  2. Department of Paediatrics, NHIC Ilsan Hospital, 1232 Paeksok-dong Ilsan-gu, Koyang-shi, Kyonggi-do, 411-719, Korea

    Su Jin Lee & Kee Hyuck Kim

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  1. Jae Il Shin
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  2. Su Jin Lee
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  3. Jae Seung Lee
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Correspondence to Kee Hyuck Kim.

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Shin, J.I., Lee, S.J., Lee, J.S. et al. Intravenous dexamethasone followed by oral prednisolone versus oral prednisolone in the treatment of childhood Henoch–Schönlein purpura. Rheumatol Int 31, 1429–1432 (2011). https://doi.org/10.1007/s00296-010-1507-1

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  • DOI: https://doi.org/10.1007/s00296-010-1507-1

Keywords

  • Henoch–Schönlein purpura
  • Intravenous dexamethasone
  • Oral prednisolone
  • Nephritis
  • Treatment outcome