Henoch-Schonlein Purpura in North East India: Peculiarities in presentation

Background: Henoch-Schonlein purpura (HSP) is the most common vasculitis of childhood and is characterized by leukocytoclastic vasculitis Methods: It was a retrospective study of children admitted with HSP in our department over a period of 7 years (January 2010 till December 2016). Results: Twenty-three children with a diagnosis of HSP were identified during the study period. The mean age was 9.4 years (4 years to 16 years). There were 15 girls and 8 boys with a male: female ratio of 1:1.9. The youngest child, who presented to us, was 4 years old and most (73.9%) children belonged to the 5-12 years age group. Forty percent of children presented in the months of January to March. Major manifestations were rash (100%), joint pain (52%), renal involvement (52%), and abdominal pain (47.8%). There were 3 (13.0%) children who presented with systemic manifestations before the appearance of the rash. One child has MPGN, 2 years preceding the onset of rash. There was no mortality. Most children recovered well; 6 (26%) had persistent hypertension and 3 (13%) had persistent proteinuria. The hypertensive emergency was seen in 2 children. One child had intussusceptions which spontaneously resolved. Conclusion: Ours is the first study from northeast India on Henoch schonlein purpura documenting certain peculiarities in the presentation. This underscores the wide spectrum of presentations that is possible in HSP.