J Korean Soc Pediatr Nephrol.  2000 Dec;4(2):111-119.

Clinicopathological Evaluation of Childhood Henoch-Schonlein Purpura(HSP) Nephritis withNephrotic Syndrome

• Kang HH
• Yoon KL
• Cho BS

Abstract

PURPOSE: Henoch-Sch nlein purpura(HSP) is a common pediatric disease presenting most frequently with skin, gastrointestinal, joint and renal manifestations. The prognosis of HSP is mainly determined by the involvement of the kidney, but prognostic markers have not been established. We evaluated the patients who have HSP nephritis with nephrotic syndrome. METHOD: Clinical manifestations and laboratory findings were observed and analyzed in 34 cases with HSP which were manifested by nephrotic syndrome, hospitalized at Kyung Hee university Hospital during the period from Jan. 1990 to Dec. 1998.
RESULTS
1) Male to female ratio was 1.3:1, and mean age at onset was 8.3 year. 2) Mean duration from symptom onset to renal biopsy was 10.5 weeks. 3) Proportion of patients presenting with acute nephritis was 32.4%, gross hematuria 17.6%, microscopic hematuria 50%. 4) The findings of renal biopsy were 20 cases of grade II, 11 cases of grade III, 2 cases of grade I, 1 case of grade IV according to classification by ISKDC. 5) Patients with grade I were recovered with no residual defect, but patients with grade IV shows active renal disease(states C).
CONCLUSION
Among the patients with Henoch-Sch nlein purpura accompanying nephrotic syndrome, more aggressive treatment might be needed in patients showing crescents formation on renal biopsy. A prospective study will be needed to explore the progression of this disease.

Keyword

H-S purpura; nephrotic syndrome; renal biopsy; acute nephritis

MeSH Terms

Biopsy
Classification
Female
Hematuria
Humans
Joints
Kidney
Male
Nephritis*
Nephrotic Syndrome
Prognosis
Purpura
Skin