Analysis of clinical and pathological characteristics in 167 children with Henoch Schönlein purpura nephritis

Abstract

Objective To investigate the clinical, renal pathological characteristics of Henoch Schonlein purpura nephritis (HSPN) in children. Methods One hundred and sixty-seven children hospitalized with HSPN from Jan.2008 to Dec.2011 in the First Affiliated Hospital of Zhengzhou University were divided into 2 groups by 24-hour urinary protein quantity: group A with 24-hour urinary protein quantity <25 mg/kg, group B with 24-hour urinary protein quantity ≥25 mg/kg.Age of onset, gender, injury time of kidney, clinical manifestations, 24-hour urinary protein quantity and renal pathological grades of the 2 groups were collected and analyzed. Results In 167 HSPN children, the ratio of male to female was 1.8︰1.0.The ages from 5 to 10 years old accounted for 70.7%.Renal injury time was from a day to 5 months, 91.6% of the HSPN children occurred renal damage within 1 month.HSPN children had clinical signs of gastrointestinal involvement in 56 cases(33.5%), at the same time, the digestive tract and joint involvement in 52 cases(31.1%). Pathological classification of 6 grades: 8 cases(4.8%) of grade Ⅰ; 32 cases(19.2%) of grade Ⅱ; 124 cases(74.3%) of grade Ⅲ; 3 cases(1.8%) of grade Ⅳ; no grade Ⅴ or Ⅵ.Pathologic grade of group B was higher than group A, and the difference was significant(P<0.05). Conclusions The HSPN children, expecially the boys, were more found with digestive tract injury or multiple organ damage.Most HSPN children occurred renal damage within 1 month.The renal biopsy of HSPN children should be positive, especially when the 24-hour urinary protein quantity is ≥25 mg/kg. Key words: Purpura nephritis; Renal biopsy; Pathology; Urinary protein; Child