[TRENDS IN HOSPITALIZATION OF CHILDREN WITH HENOCH -SCHONLEIN PURPURA].

BACKGROUND: Traditionally, most children diagnosed with Henoch-Schonlein Purpura (HSP) were hospitalized. This policy gradually changed towards selective hospitalization, yet there are still no criteria for admitting pediatric patients with HSP. OBJECTIVES: To examine the clinical features and criteria for hospitalization of pediatric patients with HSP. METHODS: A retrospective analysis was conducted of medical records of pediatric patients with HSP examined in the emergency department (ED) of Schneider Children's Medical Center, during 2005-2015. We compared children who were admitted with those not admitted to the hospital. RESULTS: During the study period, 116 children diagnosed with HSP were examined in the ED of Schneider Children's Medical Center: 14(12%) were admitted at first referral, and 22 (19%) of the children were hospitalized subsequently. The average age of all the children with HSP was 7.4 years, 57% were boys, and approximately 10% of the children had additional diseases, most of them auto-inflammatory. The main indications for hospitalization were gastrointestinal involvement (abdominal pain or bleeding), renal involvement (hematuria or proteinuria), and inability to walk. Most of these symptoms were also present in the children who were not admitted. CONCLUSIONS: Approximately 30% of the children were admitted to the hospital, most of them not at first referral. No clear criteria for admission were found, except for gastrointestinal bleeding.

Long-Term Follow-Up of Infants After a Brief Resolved Unexplained Event-Related Hospitalization.

OBJECTIVE: A brief resolved unexplained event (BRUE) in infancy is a common reason for visiting the emergency department. However, little is known about the long-term outcomes of such an event. This study evaluates future mortality, morbidity, and/or developmental outcome after a BRUE. METHODS: A single-center retrospective study performed in 2009 to 2013 included 87 hospitalized infants (<1 year old) fitting the American Academy of Pediatrics' criteria of a lower-risk BRUE, with 2 exceptions: no time limit to duration of episode and no age limit of ≥60 days. Hospitalized infants were followed up for up to 5 years via a telephone questionnaire to assess mortality rates, developmental delay, neurological/cardiovascular morbidity, and future hospitalizations. RESULTS: Most infants (94%) who experienced a BRUE were hospitalized before 6 months of age. No cases of mortality occurred. In terms of developmental outcome, 1 child (1.15%) was diagnosed as having a global developmental delay and 12 (13.7%) with a language delay, similar to prevalence rates by age in the United States. Three children (3.4%) were diagnosed as having an autism spectrum disorder, with higher prevalence rates than the global average. Simple febrile and nonfebrile seizures were seen at a rate similar to the general population. None of the children developed cardiovascular disease. Rehospitalization occurred in 22% of cases: 90% for common acute pediatric causes and 10% for recurrent choking events secondary to gastroesophageal reflux disease. CONCLUSIONS: Low-risk hospitalized infants younger than 1 year who experienced a BRUE seem to generally have an excellent prognosis.