Local leukocyte proliferation as a target for cyclophosphamide in the treatment of Henoch-Schönlein purpura nephritis grade VI.

Abstract

Henoch-Schönlein purpura nephritis (HSPN) is one of the most common types of chronic glomerulonephritis in children; however, there have been few reports on the pathogenesis and management of grade VI HSPN. We present the case of a 6-year-old boy with grade VI HSPN accompanied by severe nephrotic syndrome and hypocomplementaemia. Immunohistological studies revealed profound glomerular accumulation of CD45- and CD68-positive inflammatory cells. Moreover, some cells expressed the proliferating marker proliferating cell nuclear antigen. His proteinuria and general oedema persisted despite repeated high-dose steroid therapy; however, these clinical symptoms immediately improved after beginning treatment with cyclophosphamide (CyP). Grade VI HSPN was successfully treated with steroids and immunosuppressants. Among immunosuppressive drugs, CyP was considered the most effective.

• Authors: Masahiro Kaneko, Yohei Ikezumi, Takeshi Yamada, Hiroya Hasegawa, Utako Kaneko, Akihiko Saitoh
• Journal: Nephrology (Carlton, Vic.) (Nephrology (Carlton)) Vol. 21 Issue 1 Pg. 68-71 (Jan 2016) ISSN: 1440-1797 [Electronic] Australia
• PMID: 26693846 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2015 Asian Pacific Society of Nephrology.

Chemical References

• Glucocorticoids
• Immunosuppressive Agents
• Cyclophosphamide

Topics

• Biopsy
• Cell Proliferation (drug effects)
• Child
• Cyclophosphamide (therapeutic use)
• Drug Therapy, Combination
• Fluorescent Antibody Technique
• Glomerulonephritis, Membranoproliferative (diagnosis, drug therapy, immunology)
• Glucocorticoids (therapeutic use)
• Humans
• IgA Vasculitis (diagnosis, drug therapy, immunology)
• Immunosuppressive Agents (therapeutic use)
• Kidney (drug effects, immunology, pathology)
• Leukocytes (drug effects, immunology, pathology)
• Male
• Nephrotic Syndrome (drug therapy, immunology)
• Severity of Illness Index
• Treatment Outcome