Relationship between renal pathology and glomerular podocyte injury in childhood Henoch-Schönlein purpura nephritis

Abstract

Objective To explore the relationship between renal pathology and glomerular podocyte injury in childhood Henoch-Schonlein purpura nephritis(HSPN). Methods Renal pathological types of 72 children suffering from HSPN were reviewed during the period of Jan.2008 to Jan.2011 from Nanjing General Hospital of Nanjing Command.In those cases, grade in pathology and immunofluorescence types were acquired.Podocyte injury was classified by electron microscope.The relationship between podocyte injury and grade in pathology was analyzed. Results Pathological findings were classified, grade Ⅱ in 34 cases(47.2%) and grade Ⅲ in 38 cases(52.8%). Glomerular podocyte injury was classified by electron microscope as food processes of podocyte fused extensively in 21 cases; food processes of podocyte fused segmental in 35 cases, food processes of podocyte without fusion in 11 cases.There was without renal glamorous in nephridial tissue by electron microscope in 5 cases.Cases with foot process of podocyte fused extensively were more grade Ⅲ than those cases with foot process fused segmental and without fusion.According to renal immunofluorescence pathology, IgA+ IgM+ IgG type was mostly in cases with foot process of podocyte fused extensively, IgA+ IgG type was mostly in cases with food processes of podocyte fused segmental and IgA type was mostly in cases with food processes of podocyte without fusion. Conclusions In childhood HSPN, renal pathology changed not only expressing on mesangial cell hyperplasia but also podocyte injury.The more seriously on the degree of podocyte injury, more obviously in pathologic change. Key words: Henoch-Schonlein purpura nephritis; Renal pathology; Glomerular podocyte injury; Child