435 Severe skin manifestations in patients with Henoch Schoenlein purpura (HSP) in five tertiary centres in Croatia between 2009 and 2019

• Published in: Archives of disease in childhood 2021-10, Vol.106 (Suppl 2), p.A182-A182
• Main Authors: Sršen, Saša, Varga, Mateja Batnožić, Šapina, Matej, Šestan, Mario, Čekada, Nastasia, Ovuka, Aleksandar, Frković, Marijan, Gagro, Alenka, Jelušić, Marija
• Format: Article
• Language: English
• Subjects: Abstracts; Anatomy; Central nervous system; Children & youth; Data Analysis; Exanthema; Females; Laboratories; Males; Patients; Pediatrics; Prediction models; Purpura; Skin; Statistical analysis; Statistical Significance
• ISSN: 0003-9888; 1468-2044
• DOI: 10.1136/archdischild-2021-europaediatrics.435

To evaluate characteristics of patients with severe skin manifestations of Henoch Schoenlein purpura (HSP) in five tertiary centres in Croatia in time period from 2009 until 2019.Retrospective statistical chart analysis of clinical symptoms and laboratory parameters of patients with HSP was done. Severe skin manifestations were defined as haemorrhagic bullous, ulcerated or necrotic lesions.During observed time period 583 patients (303 boys and 280 girls) were admitted to hospital due to HSP. Prevalence of severe skin manifestations was 2.41% (14 patients, CI 1.32 – 4.003%). Severe skin manifestations occurred more often in boys than in girls with a difference on a margin of statistical significance (11 boys, 3 girls, p=0.057). Patients with severe skin manifestations were more prone to relapses than those with milder skin forms (severe 28.57%, milder 18.66%), with most notable difference in patients with 2 relapses of disease (severe 14.29%, milder 3.17%, p=0.029).We were able to isolate infectious trigger of disease more often in patients with milder form of disease than in those with more severe (milder 38.42%, severe 7.69%, p=0.036).Patients with severe skin manifestations had more often gastrointestinal system affected than those with milder skin forms (severe 70%, milder 36.03%, p=0.043). There was no statistically significant difference between those two groups in other organs involvement (kidneys, joints, central nervous system, lung).Regarding distribution of skin rash, patients with severe skin manifestations more often had a rash on a trunk, with a difference on a margin of statistical significance (severe 85.71%, milder 57.19%, p=0.051).There was no statistical difference between two groups in most of other clinical and laboratory parameters. Only blood leukocyte levels were near to statistical significance with higher levels in patients with severe skin manifestations (12.1*109/L (SD 10-17.62):10.71*109/L (SD 8.45-13.42), p=0.059).Patients with severe skin manifestations of HSP were more prone to relapses, and had gastrointestinal symptoms more often affected than those with milder forms, but less often had infectious trigger isolated. There was no significant statistical difference in other clinical symptoms and laboratory parameters. We couldn’t set predictive model for disease outcome based on these data. Small number of patients with severe manifestations and retrospective data analysis could be the reason. Perhaps better structured prospec