Rheumatoid purpura in children

With the aim of analyzing the clinical and evolutionary features of rheumatoid purpura in children, we retrospectively studied 111 cases collected in a pediatric department over a 19-year period. The sex ratio was 1.4. The mean age was 6 years (1-16 years). Diagnosis was based on the constant presence of a cutaneous syndrome consisting of symmetrical purpuric lesions electively affecting the declive regions, associated with an articular syndrome (84 cases) and/or a digestive syndrome (72 cases). Renal involvement was observed in 30% of cases. Nephrotic syndrome was noted in 3 patients, 2 of whom developed renal failure. The most frequent complications were digestive (21.6%). Treatment was purely symptomatic in the majority of cases (95.5%). Four patients required corticosteroid therapy because of severe abdominal pain or nephrotic syndrome. Only one patient required the introduction of a cortico-resistant nephrotic syndrome. The majority of patients had a favourable outcome. Relapse or recurrence was noted in 7 cases and 4 respectively.