Is Helicobacter Pylori Infection The Cause Or Risk Factor For Henoch Schonlein Purpura In Han Children

BackgroundDespite the fact that the etiology of Henoch Schonlein purpura(HSP) remains elusive, the prevailing theories have linked Helicobacter pylori(H. pylori) and development of HSP in genetically susceptible individuals. The objective of this study was to observe the potential H.pylori infection status in Pediatric patients diagnosed with HSP with prospective data collected from the children enrolled consecutively.MethodThis was a prospective study which investigated children with HSP who were admitted in general pediatrics ward in Union Hospital affiliated to Fujian Medical University during the period of September, 1st 2013 to January, 30 th 2015. A total of 179 children were enrolled in the study. 60 children who presented with gastrointestinal complaints without the diagnoses of HSP were recruited as control group and 119 children with the diagnoses of HSP were recruited in a study group. The diagnosis of HSP met the inclusion criteria of HSP from China Association of Pediatrics. 13 C Urea Breath Test(UBT) was used for the diagnosis of H. pylori infection was used as a screening tool for all subjects that met the inclusion criteria. The demographic characteristics and clinical manifestations of the subjects were recorded and analyzed.ResultsAmong the study population, 72(61%) were boys with average age of 6.85± 0.52 years old and47(39%) were girls with mean age of 6.91± 0.67 years old. There were 71(59.66%) of the patients in the study subjects presenting with HSP who had evidence of H. pylori gastric colonization. There was no statistical significance when two genders in a study group were compared for H. pylori infection status after adjustment for age; X2(1, N = 119) = 1.278,P > 0.05.Among the overall study subjects with H. pylori infection, 74(62%) presented with typical diffuse form of HSP with symptoms of palpable purpura, abdominal pain, hematochezia, diffuse joints pain and hematuria, 11(18.89%) subjects presented with purpura, abdominal pain,hematochezia and hematuria. The study depicted 24(40%) from the control group and 71(59.66%)from the study group had evidence of H. pylori infection(X2=4.285, P<0.05.ConclusionThere was higher infection rate in Han children with H.pylori. The potential association between HSP and with H. pylori infection deserves a special attention especially in children with HSP presenting with gastrointestinal manifestations.