Worldwide Distribution and Extracutaneous Manifestations of Henoch-Schönlein Purpura in Adults: Narrative Review

Blair W Harris; Luke Maxfield; Abigail Hunter; Mandy Alhajj; Byung Ban; Kayd J Pulsipher

doi:10.2196/49746

Worldwide Distribution and Extracutaneous Manifestations of Henoch-Schönlein Purpura in Adults: Narrative Review

JMIR Dermatol. 2024 Jan 25:7:e49746. doi: 10.2196/49746.

Authors

Blair W Harris¹, Luke Maxfield¹, Abigail Hunter¹, Mandy Alhajj², Byung Ban³, Kayd J Pulsipher¹

Affiliations

¹ Department of Dermatology, Sampson Regional Medical Center, Campbell University, Clinton, NC, United States.
² Department of Dermatology, Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, United States.
³ Department of Rheumatology, MedStar Georgetown University Hospital, Washington, DC, United States.

PMID: 38271008
PMCID: PMC10853858
DOI: 10.2196/49746

Abstract

Background: Henoch-Schönlein purpura (HSP), a leukocytoclastic small vessel vasculitis, exhibits both cutaneous and systemic manifestations. While predominantly observed in childhood, it may manifest in adults with more pronounced systemic involvement. Furthermore, HSP is a global phenomenon showcasing epidemiological and systemic variances.

Objective: This study aims to scrutinize extracutaneous manifestations in adults with HSP, discerning distinctions according to geographical regions on a worldwide scale.

Methods: A comprehensive search encompassing PubMed, Embase, Cochrane Library, and Web of Science was executed, covering papers published from January 1, 1970, to December 1, 2019. Keywords used included "Henoch-Schönlein purpura," "henoch schonlein purpura+adult," "IgA vasculitis+adult," "HSP+adult," and "IgAV." A total of 995 publications were identified, from which 42 studies encompassing 4064 patients were selected, with a predominant focus on cases reported in Asia, Europe, and the Americas.

Results: Among adults afflicted with HSP, European patients exhibited a higher propensity for male predominance (P<.001), gastrointestinal involvement (P<.001), and musculoskeletal complications (P<.001). Conversely, patients from the Americas were least likely to experience genitourinary involvement (P<.001).

Conclusions: HSP demonstrates a variance in distribution and extracutaneous manifestations within distinct geographical boundaries. In the adult population, European patients exhibited a higher prevalence of male gender and gastrointestinal and musculoskeletal involvement. Asian patients were more predisposed to genitourinary involvement when compared to their American counterparts. The establishment of prospective studies using standardized reporting measures is imperative to validate the relationships unveiled in this investigation.

Keywords: HSP; Henoch-Schönlein purpura; IgA vasculitis; IgAV; extracutaneous manifestations; immunoglobulin A vasculitis; narrative review.

©Blair W Harris, Luke Maxfield, Abigail Hunter, Mandy Alhajj, Byung Ban, Kayd J Pulsipher. Originally published in JMIR Dermatology (http://derma.jmir.org), 25.01.2024.

Publication types

Review