Resumo

MAKHWARENE, M; MCCULLOCH, M I  e  BUYS, H. A retrospective descriptive review of children diagnosed with Henoch-Schönlein purpura at Red Cross War Memorial Children's Hospital over a 5-year period (2015 - 2019). S. Afr. j. child health [online]. 2025, vol.19, n.3, pp.68-73. ISSN 1999-7671.  https://doi.org/10.7196/SAJCH.2025.v19i3.2257.

BACKGROUND. Limited data are available on the prevalence, variation in clinical features and outcomes of IgA vasculitis in low-middle-income countries. OBJECTIVE. To describe IgA vasculitis cases encountered at a South African (SA) children's hospital. METHODS. A retrospective review of patients with a discharge diagnosis of IgA vasculitis at Red Cross War Memorial Children's Hospital between 2015 and 2019. Patient demographics, clinical characteristics, laboratory findings, management and short-term outcomes were summarised using conventional descriptive statistics. RESULTS. The mean age of the study sample (N=49) was 77 months; male-to-female ratio was 1:1. Rash presented in 48 children (97%), arthralgia in 41 patients (84%) and abdominal pain in 18 patients (37%). Oedema manifested as scrotal oedema in one patient and as facial oedema in three cases. Kidney involvement was evident in 26 cases (53%), with associated proteinuria or haematuria, while isolated microscopic haematuria occurred in six patients (12%). Complications were infrequent: five patients (10%) had IgA nephritis on biopsy and one (2%) had a gastrointestinal bleed. The mean (standard deviation) length of hospital stay was 1.6 (2) days. At one year of follow-up, two patients (4%) had persistent proteinuria; only one patient (2%) still had haematuria. CONCLUSION. The clinical course of IgA vasculitis in this cohort of SA children was mostly self-limiting, consistent with international literature. However, patients with persistent haematuria or proteinuria required longer-term follow-up. Collaborative studies in SA and sub-Saharan Africa may provide a more accurate picture of the epidemiology of childhood IgA vasculitis and its complication rates.

Palavras-chave : IgA vasculitis; Henoch-Schönlein purpura; HSP; children; proteinuria; Africa.

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