In Reply.—We thank Dr Kurokawa and colleagues who support new data on the potential etiologic role of HBV in some cases of S-H purpura. The 7-year-old boy with S-H purpura reported in the letter seems to have evidence of active HBV replication (HBeAg positivity) and liver disease.1 Even if anti–HB-core IgM is lacking, we do not understand why a relationship between HBV and S-H purpura in this case is unlikely.2 Furthermore, two other cases of HBV infection and S-H purpura are reported in the letter.3
Schönlein-Henoch purpura is a multietiologic syndrome with probably different pathogenetic mechanisms.4 The aim of our report was mainly to extend such etiologic factors and not to support the hypothesis that HBV is the main cause of S-H syndrome.
MAGGIORE G, De GIACOMO C, MARTINI A. Hepatitis B Virus and Schönlein-Henoch Purpura-Reply. Am J Dis Child. 1985;139(9):861-862. doi:10.1001/archpedi.1985.02140110015014