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Streptococcal infection in childhood Henoch-Schönlein purpura: a 5-year retrospective study from a single tertiary medical center in China, 2015–2019

Authors
  • Fan, Guo Zhen1, 2
  • Li, Rui Xue2
  • Jiang, Qi2
  • Niu, Man Man2
  • Qiu, Zhen2
  • Chen, Wei Xia2
  • Liu, Hui Hui2
  • Ruan, Jin Wei2
  • Hu, Peng1, 2
  • 1 Chaohu Hospital of Anhui Medical University, No.64 Chaohu North Road, Hefei, 230022, People’s Republic of China , Hefei (China)
  • 2 The First Affiliated Hospital of Anhui Medical University, No. 218 Ji-Xi Road, Hefei, 230022, People’s Republic of China , Hefei (China)
Type
Published Article
Journal
Pediatric Rheumatology
Publisher
Springer Science and Business Media LLC
Publication Date
Jun 02, 2021
Volume
19
Issue
1
Identifiers
DOI: 10.1186/s12969-021-00569-3
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThe present study focuses on the associations of streptococcal infection with the clinical phenotypes, relapse/recurrence and renal involvement in Henoch-Schönlein purpura (HSP) children.MethodsTwo thousand seventy-four Chinese children with HSP were recruited from January 2015 to December 2019. Patients’ histories associated with HSP onset were obtained by interviews and questionnaires. Laboratory data of urine tests, blood sample and infectious agents were collected. Renal biopsy was performed by the percutaneous technique.Results(1) Streptococcal infection was identified in 393 (18.9%) HSP patients, and served as the most frequent infectious trigger. (2) Among the 393 cases with streptococcal infection, 43.0% of them had arthritis/arthralgia, 32.1% had abdominal pain and 29.3% had renal involvement. (3) 26.1% of HSP patients relapsed or recurred more than 1 time within a 5-year observational period, and the relapse/recurrence rate in streptococcal infectious group was subjected to a 0.4-fold decrease as compared with the non-infectious group. (4) No significant differences in renal pathological damage were identified among the streptococcal infectious group, the other infectious group and the non-infectious group.ConclusionsStreptococcal infection is the most frequent trigger for childhood HSP and does not aggravate renal pathological damage; the possible elimination of streptococcal infection helps relieve the relapse/recurrence of HSP.

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