Miguel Saps1, Gati Dhroove, Ashish Chogle. 1. Department of Pediatric Gastroenterology, Children's Memorial Hospital, Northwestern University, 2300 N Children's Plaza, PO Box #57, Chicago, IL 60614, USA. msaps@childrensmemorial.org
Abstract
BACKGROUND: Pain predominant functional gastrointestinal disorders such as irritable bowel syndrome may develop as sequelae to acute infectious gastroenteritis. Henoch-Schonlein purpura is a vaculitis that causes an inflammatory insult to the intestinal mucosa. OBJECTIVE: To assess whether patients with Henoch-Schonlein purpura are more likely to develop functional gastrointestinal disorders in long-term follow-up than controls. PATIENTS AND METHODS: Families of children diagnosed with Henoch-Schonlein purpura from 2002 to 2009 were contacted at least 6 months after an acute episode. Parents completed a validated questionnaire to diagnose functional gastrointestinal disorders according to Rome III criteria. RESULTS: Thirty-eight patients (mean 9.9 years, range 3-22 years, 19 males) and 38 controls (mean 9.5 years, range 1-24 years, 21 males) were recruited. Of the patients, 81% had abdominal pain with Henoch-Schonlein purpura presentation. Initial abdominal pain had resolved in all cases. At the time of study, 60.5% patients and 2.6% controls had abdominal pain. Children in Henoch-Schonlein purpura group were diagnosed with various functional gastrointestinal disorders: Irritable bowel syndrome in 11%, functional abdominal pain syndrome in 8%, and functional abdominal pain in 2.8%. Steroid usage was associated with higher incidence of abdominal pain (87.5%) at the time of the study as compared to no steroid usage (40.9%), p = 0.0065. CONCLUSIONS: Patients with Henoch-Schonlein purpura are at an increased risk of developing pain predominant functional gastrointestinal disorders. The presence of abdominal pain and use of steroids at presentation of Henoch-Schonlein purpura are associated with higher incidence of pain predominant functional gastrointestinal disorders.
BACKGROUND:Pain predominant functional gastrointestinal disorders such as irritable bowel syndrome may develop as sequelae to acute infectious gastroenteritis. Henoch-Schonlein purpura is a vaculitis that causes an inflammatory insult to the intestinal mucosa. OBJECTIVE: To assess whether patients with Henoch-Schonlein purpura are more likely to develop functional gastrointestinal disorders in long-term follow-up than controls. PATIENTS AND METHODS: Families of children diagnosed with Henoch-Schonlein purpura from 2002 to 2009 were contacted at least 6 months after an acute episode. Parents completed a validated questionnaire to diagnose functional gastrointestinal disorders according to Rome III criteria. RESULTS: Thirty-eight patients (mean 9.9 years, range 3-22 years, 19 males) and 38 controls (mean 9.5 years, range 1-24 years, 21 males) were recruited. Of the patients, 81% had abdominal pain with Henoch-Schonlein purpura presentation. Initial abdominal pain had resolved in all cases. At the time of study, 60.5% patients and 2.6% controls had abdominal pain. Children in Henoch-Schonlein purpura group were diagnosed with various functional gastrointestinal disorders: Irritable bowel syndrome in 11%, functional abdominal pain syndrome in 8%, and functional abdominal pain in 2.8%. Steroid usage was associated with higher incidence of abdominal pain (87.5%) at the time of the study as compared to no steroid usage (40.9%), p = 0.0065. CONCLUSIONS:Patients with Henoch-Schonlein purpura are at an increased risk of developing pain predominant functional gastrointestinal disorders. The presence of abdominal pain and use of steroids at presentation of Henoch-Schonlein purpura are associated with higher incidence of pain predominant functional gastrointestinal disorders.
Authors: Sally D Parry; Rosamund Stansfield; Diana Jelley; Wendy Gregory; Elizabeth Phillips; J Roger Barton; Mark R Welfare Journal: Am J Gastroenterol Date: 2003-09 Impact factor: 10.864
Authors: Sally D Parry; Rosamund Stansfield; Diana Jelley; Wendy Gregory; Elizabeth Phillips; J Roger Barton; Mark R Welfare Journal: Am J Gastroenterol Date: 2003-02 Impact factor: 10.864
Authors: Miguel Saps; Licia Pensabene; Lucio Di Martino; Annamaria Staiano; Joshua Wechsler; Xiaotian Zheng; Carlo Di Lorenzo Journal: J Pediatr Date: 2008-02-14 Impact factor: 4.406
Authors: Miguel Saps; Roopa Seshadri; Marcelo Sztainberg; Gilda Schaffer; Beth M Marshall; Carlo Di Lorenzo Journal: J Pediatr Date: 2008-11-28 Impact factor: 4.406