Reumatizam, Vol. 62 No. 2, 2015.
Professional paper
VASCULITIDES IN CHILDHOOD: A RETROSPECTIVE STUDY IN A PERIOD FROM 2002 TO 2012 AT THE DEPARTMENT OF PAEDIATRICS, UNIVERSITY HOSPITAL CENTRE ZAGREB
Marija Jelušić
Lucija Kostić
Marijan Frković
Maša Davidović
Ivan Malčić
Abstract
Th e aim of our study was to analyze clinical features, laboratory
fi ndings, treatment, course and outcome of diff erent
types of vasculitis in children. All children aged up to 18 years
that have been diagnosed with a vasculitis disorder from 2002.
to 2012. at the Department of Paediatric, University Hospital
Centre Zagreb according to EULAR/PRES/PRINTO criteria
were included in the study. Vasculitis was diagnosed in 180
children, 101 girls and 79 boys, mean age 7.19±3.7 years, with
an average follow-up of 5,58±3,28 years. Most of the children
(155 or 86%) were diagnosed with Henoch-Shönlein purpura
(HSP), polyarteritis nodosa (PAN) was diagnosed in 6 children
(3.3%), isolated cutaneous leukocytoclastic vasculitis in
5 (2.8%), Takayasu arteritis (TA) and Kawasaki disease in 2
(1.1%) respectively, hypocomplementemic urticarial vasculitis
in one patient (0.5%) and other types of vasculitis in 10
(5.5%) patients (vasculitides in systemic connective tissue
disorders in 7 and unclassifi ed vasculitides in 3 patients).
All patients had elevated infl ammatory markers (C-reactive protein and erythrocyte sedimentation rate). Anti-neutrophil
cytoplasmatic antibodies (ANCA) were positive only in one
patient, suff ering from microscopic polyangiitis. Treatment
modality in most patients were NSAIDs, while children with
kidney or gastrointestinal system aff ection were treated with
glucocorticoids and/or immunosuppresive drugs. Biological
therapy (anti-CD20, rituximab) was used in patients with
most severe symptoms. One child (0.56%), suff ering from
microscopic polyangiitis, died due to kidney failure during
the follow-up. Forty patients (22.6%) had one disease relapse,
while 6 (3.4%) had two relapses. In conclusion, we found
some diff erences in laboratory parameters (e.g. lower incidence
of elevated antistreptolysin O titer in HSP) and epidemiological
data (e.g. higher prevalence of PAN in female
children) in comparison to data from available studies, while
other clinical features, laboratory fi ndings, disease outcome
and treatment were similar.
Keywords
vasculitis; classifi cation; treatment; outcome; children
Hrčak ID:
182719
URI
Publication date:
9.11.2015.
Visits: 1.319 *