The role of biochemical parameters in the diagnosis and treatment of patients with Henoch-Schonlein purpura

Introduction and Purpose: Henoch-Schönlein Purpura (HSP), first described by William Heberden, is the most common small-vessel vasculitis in children, primarily affecting the skin, joints, gastrointestinal tract, and kidneys. Most patients recover completely with supportive care, without the need for specific treatment. However, in cases with severe organ involvement, treatment strategies are determined based on the type and severity of the affected organ. This study aimed to evaluate the demographic, clinical, and laboratory characteristics of patients diagnosed with HSP at the Department of Pediatrics, Dicle University Faculty of Medicine, and to assess the relationship of these parameters with steroid use. Materials and Methods: This study is a clinical, retrospective, cross-sectional analysis. Data were collected from patients diagnosed with HSP between January 1, 2014, and January 1, 2024, at the Department of Pediatrics, Dicle University Faculty of Medicine. The patients were divided into two groups based on steroid use, and their data were compared accordingly. Results: The total number of cases in the study is 133. The most frequent presentations occurred in the 6–11 age group (58.7%), the most frequent gender change is girl (n=70) (52,6%) and during the spring season (29.3%). The peak months for admissions were May, October, and December, while the highest number of cases was recorded between 2014 and 2017. Clinically, abdominal pain was observed in 50.4% of patients and arthritis in 40.6%. Occult blood in stool was positive in 16.5% of cases, while hematuria and proteinuria were detected in 26.3% and 18% of patients, respectively. Examination of the affected body regions revealed that the lower extremities were most commonly involved (42.8%). When comparing patients who received steroid treatment with those who did not, involvement of both upper and lower extremities as well as the hips was significantly more frequent in the steroid-treated group (p<0.05). Abdominal pain and proteinuria were also significantly more prevalent in the steroid group, which also showed lower serum albumin levels (p<0.05). No significant differences were found between the groups in terms of age, length of hospital stay, complete blood count, or other biochemical parameters. Conclusion: These findings suggest that in Henoch-Schönlein purpura (HSP), decisions regarding steroid use should be based not only on laboratory results but also on the anatomical extent of involvement and clinical manifestations. Early identification of these parameters is crucial for preventing potential complications.