Abstract
Aim
The aims of this study were to evaluate the characteristics of childhood vasculitides and to establish the first registry in Turkey, an eastern Mediterranean country with a white population.
Patients and methods
A questionnaire was distributed to the main referral centers asking for the registration of the Henoch-Schönlein purpura (HSP) patients in the last calendar year only and 5 years for other vasculitides. Demographic, clinical, and laboratory data were assessed.
Results
Vasculitic diseases were registered from 15 pediatric centers. These centers had a fair representation throughout the country. In the last calendar year, incidences were as follows: HSP 81.6%, Kawasaki disease (KD) 9.0%, childhood polyarteritis nodosa (C-PAN) 5.6%, Takayasu arteritis (TA) 1.5%, Wegener’s granulomatosis 0.4%, and Behçet disease 1.9%. There was no clear gender dominance. The mean age was 11.05±4.89 years. Acute phase reactants were elevated in almost all, highest figures being in C-PAN. Renal involvement was present in 28.6% of HSP and 53% of the C-PAN patients. Abdominal aorta was involved in all TA patients. Among the C-PAN patients, 25% had microscopic PAN with necrotizing glomerulonephritis; antineutrophil cytoplasmic antibody was positive in those who were studied. Among the patients, 12.5% and 15% had classic PAN and cutaneous PAN, respectively. The remaining majority were classified as systemic C-PAN diagnosed with biopsies and/or angiograms demonstrating small to midsize artery involvement. The overall prognosis was better than reported in adult series.
Conclusion
This is the largest multicenter study defining the demographic data for childhood vasculitides. The distribution of childhood vasculitides was different in our population where KD is much less frequent, whereas HSP constitutes an overwhelming majority. C-PAN was more frequent as well.
Similar content being viewed by others
References
Ozen S (2004) Vasculitis in children. In: Isenberg DA, Maddison PJ, Woo P, Glass D, Breedveld FC (eds) Oxford textbook of rheumatology, 3rd edn. Oxford University Press, Oxford, pp 993–997
Watts RA, Lane SE, Scott DG, Koldingsnes W, Nossent H, Gonzalez-Gay MA, Garcia-Porrua C, Bentham GA (2001) Epidemiology of vasculitis in Europe. Ann Rheum Dis 60:1156–1157
Yanagawa H, Yashiro M, Nakamura Y et al (1995) Epidemiologic pictures of KD in Japan: from the nationwide incidence survey in 1991 and 1992. Pediatrics 95:475
Shulman ST, McAuley JB, Pachman LM et al (1987) Risk of coronary abnormalities due to KD in urban area with small Asian population. Am J Dis Child 141:420
Ozen S, Anton J, Arisoy N et al (2004) Juvenile polyarteritis: results of a multicenter survey of 110 children. J Pediatr 145:517–522
Mills JA, Michel BA, Bloch DA, Calabrese LH, Hunder GG, Arend WP, Edworthy SM, Fauci AS, Leavitt RY, Lie JT et al (1990) The American College of Rheumatology 1990 criteria for the classification of Henoch-Schönlein purpura. Arthritis Rheum 33:1114–1121
Japan Kawasaki Disease Research Committee (1984) In: Diagnostic guidelines of Kawasaki disease, 4th revised edn. Japan Red Cross Medical Centre, Tokyo
Lightfoot RW Jr, Michel BA, Bloch DA et al (1990) The ACR 1990 criteria for the classification of polyarteritis nodosa. Arthritis Rheum 33:1088
Ozen S, Besbas N, Saatci U, Bakkaloglu A (1992) Diagnostic criteria for polyarteritis nodosa in childhood. J Pediatr 2:206–209
Arend WP, Michel BA, Bloch DA et al (1990) The ACR 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 33:1129–1134
Leavitt RY, Fauci AS, Blach DA et al (1990) The ACR 1990 criteria for the classification of Wegener’s granulomatosis. Arthritis Rheum 33:1101
Ozen S, Ruperto N, Dillon M, Bagga A, Barron K, Davin JC, Kawasaki T, Lindsley C, Petty R, Prieur AM, Ravelli A, Woo P (2005) EULAR/PRES endorsed consensus criteria* for the classification of childhood vasculitides * under review by the ACR. Ann Rheum Dis Dec 1. DOI 10.1136/ard.2005.046300
Falcini F (2004) Vascular and connective tissue diseases in the pediatric world. Lupus 13:77–84
Petty RE, Cassidy JT (2001) Vasculitis and its classification. In: Cassidy JT, Petty RE (eds) Textbook of pediatric rheumatology, 4th edn. Saunders, Philadelphia, PA, pp 564–568
Handa R, Wali JP, Gupta SD et al (2001) Classical PAN and microscopic polyangiitis—a clinicopathological study. J Assoc Phys India 49:314–319
Desiron Q, Zeaiter R (2000) Takayasu’s arteritis. Acta Chir Belg 100:1–6
Moriwaki R, Noda M, Yajima M, Sharma BK, Numano F (1997) Clinical manifestations of Takayasu arteritis in India and Japan—new classification of angiographic findings. Angiology 48:369–379
Bronstein DE, Dille AN, Austin JP, Williams CM, Palinkas LA, Burns JC (2000) Relationship of climate, ethnicity and socioeconomic status to Kawasaki disease in San Diego County, 1994 through 1998. Pediatr Infect Dis J 19:1087–1091
Author information
Authors and Affiliations
Consortia
Corresponding author
Rights and permissions
About this article
Cite this article
On behalf of Turkish Pediatric Vasculitis Study Group., Ozen, S., Bakkaloglu, A. et al. Childhood vasculitides in Turkey: a nationwide survey. Clin Rheumatol 26, 196–200 (2007). https://doi.org/10.1007/s10067-006-0266-6
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10067-006-0266-6