Clinical outcome of children with Henoch-Schönlein purpura nephritis.

Abstract

OBJECTIVE:

Evaluate the outcomes of pediatric patients with Henoch-Sch6nlein purpura nephritis andfind the parameters correlated with outcomes of treatment.

MATERIAL AND METHOD:

Review of medical records was performed in twenty patients diagnosed with Henoch-Schinlein purpura nephritis. Demographic data, clinical parameters and records of treatment at diagnosis and the last visit were collected and analyzed.

RESULTS:

Median age at diagnosis was 8-year-old and median follow-up time was 39 months. All patients had urine protein to creatinine ratio (UPCR) of more than 1.0 g/g while ten patients had hypoalbuminemia. Renal pathology results were class I, II, and III in 2, 14, and 4 patients respectively. Prednisolone was prescribed in all patients and cyclophosphamide was given in 13 patients. All patients had first resolution of proteinuria at median time of six months (range 2-47 months). At the last visit, 13 patients (65%) had remission of proteinuria (remission group), while seven patients (35%) became proteinuric relapse (relapse group) with UPCR > 0.2 g/g. Interestingly, the remission group had median time to first resolution of proteinuria shorter than the relapse group (6 months and 19 months, p < 0.001). Moreover, estimated glomerular filtration rate at diagnosis correlated negatively with UPCR at the last visit (r = -0.773, p = 0.001).

CONCLUSION:

Pediatric patients with Henoch-Schönlein purpura nephritis who presented with heavy proteinuria had favorable outcome after treatment. The patients who had early resolution ofproteinuria remained in remission more than those who had late resolution.

• Authors: Kwanchai Pirojsakul, Kanchana Tangnararatchakit, Panas Chalermsanyakorn, Wiwat Tapaneya-Olarn
• Journal: Journal of the Medical Association of Thailand = Chotmaihet thangphaet (J Med Assoc Thai) Vol. 95 Issue 7 Pg. 878-83 (Jul 2012) ISSN: 0125-2208 [Print] Thailand
• PMID: 22919981 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Inflammatory Agents
• Prednisolone
• Creatinine

Topics

• Adolescent
• Anti-Inflammatory Agents (therapeutic use)
• Child
• Child, Preschool
• Creatinine (urine)
• Female
• Humans
• IgA Vasculitis (complications)
• Male
• Nephritis (drug therapy, etiology)
• Prednisolone (therapeutic use)
• Proteinuria (drug therapy, etiology)
• Remission Induction
• Retrospective Studies