VASCULITIS. A TEN
YEAR STUDY AT THE INSTITUTO NACIONAL DE PEDIATRÍA, DEPARTEMENT OF INTERNAL
MEDICINE
Carbajal RL, Luna FM,
Reyn��s MJ, Rodr��guez HR, Barrios FR, Zarco RJ.
Instituto Nacional de Pediatr��a. SS
Mexico City,
Mexico
Objective: To know the incidence
of vasculitis in a third level institution.
Material and Method: 125 patients with
primary vasculitis seen at the Department of Internal Medicine of the
Instituto Nacional de Pediatr��a (National Institute of Pediatrics) from
1978 to 1998 were studied. The diagnosis was based on the American College
of Rheumatology criteria. Only the patients who met the criteria were
included.
Results:
Age of patients with the diagnosis of vasculitis ranged from 1 to 17 years
6 months (mean 6 years 1 month); 66 were female and 59 male; ratio 1.1:1.
Four of the most common vasculitis were found: Henoch-Schönlein purpura.
109 patients; 59 percent female, 44.1 percent male; 1.2:1 ratio; mean age 6
years 3 months. All the patients (100 percent) presented with two or more
diagnostic criteria; 4 patients had four criteria (3.6 percent); 84 (77
percent) had three criteria. Four renal biopsies reported segmentary
intracapillary glomerulonephritis in two, slight proliferative
intracapillary glomerulonephritis in one, segmental focal
glomerulonephritis and focal interstitial nephritis in another one.
Kawasaki��s disease. 9 patients; 5 male, 4 female; mean age, 3 years 11
months. All the patients presented with fever above 38�� C for more than 5
days, conjunctivitis and maculopapulous erythema; dry lips with fissures
and hyperemic mucosae in 88.8 percent (8 patients); cervical adenopathies
larger than 0.5 cm in 77.7 percent (7 patients); hand and feet induration,
palmar and plantar erythema in 66.6 percent (6 patients); strawberry
tongue, 44.4 percent (4 patients); hand and feet desquamation, 44.4 percent
(4 patients). Polyarteritis nodosa. 6 patients; all male; mean age, 1 year
11 months. Diastolic blood pressure was above 90 mmHg in 100 percent (6
patients); renal and mesenteric arterial microaneurysms, 83.3 percent (5
patients); hyperazotemia, 66.6 percent (4 patients); weight loss of more
than 4 kg, 50 percent (3 patients); livedo reticularis in 33.3 percent (2
patients); mononeuropathy, 16.6 percent (1 patient). Takayasu��s disease. One
patient, 14 years old who presented with diminished brachial artery pulse;
celiac and iliac arteries lesions, dilatation of the aorta and irregular
renal arteries.
Conclusions: Vasculitis diseases are
often seen in third level institutions. Henoch-Schönlein purupura is the
most frequent, whereas other reports indicate that Kawasaki��s disease is
more common. In our study it was the second most common vasculitis. For
many years polyarteritis was believed to be a disease of adults; however it
also occurrs in children. The same is true for Takayasu��s disease, although
it is prevalent in adults.