Henoch-Sch(o)nlein purpura complicated by pancreatitis in children: Clinical features, treatment and follow-up analysis

doi:10.19538/j.ek2018010616

Abstract：Objective To investigate the clinical manifestations,therapeutic methods and follow-up results of children with Henoch-Sch(o)nlein purpura (HSP) complicated by pancreatitis.Methods The clinical data of children with HSP complicated by pancreatitis treated in Beijing Children's Hospital between Jan 2013 and Jun 2016 were retrospectively analysed.Gender,the onset age,clinical manifestations,laboratory examination,imaging examination,treatment and curative effects were investigated.Results Totally 18 cases of HSP complicated by pancreatitis were found among all 7217 cases.The incidence of complications was 0.25％.The average onset age was (9.75±3.75) years old.The average level of serum lipase was (220.93± 105.22) U/L (reference value 0-39 U/L) and serum amylase was (541.25 ± 170.61) U/L (reference value 0-125 U/L).Six cases had history of prodromal infection of Mycoplasma pneumoniae;4 cases had anatomical deformity of cholecystic duct and pancreas.All 18 cases were treated effectively with glucocorticoid.The treatment was effective while administration courses was (38.27 ±9.54) days.The time to resume normal mouth food in take was (5.71 ± 3.43) days when abdominal pain and vomiting disappeared.Time of serum lipase recovery was 8-50 days and median duration was 27.Time of serum amylase recovery was 2-26 days and median duration was 14.Follow-up lasted for half a year,and 17 cases of patients had good recovery and 1 case had pancreatic pseudocyst on imaging examination.Conclusion We should pay attention to pancreatitis in HSP patients,especially those who has infection of Mycoplasma pneumoniae or anatomical deformity of cholecystic duct and pancreas.Glucocorticoid is effective.Pancreatin inhibitors are considered as prescription in case of gastrointestinal hemorrhage.Serum lipase and amylase may fluctulate in increasing the amount of food.The overall prognosis is satisfactory.