Abstract
IntroductionHenoch-Schönlein purpura nephritis (HSN) is defined as Henoch-Schönlein purpura with kidney involvement, including hematuria and/or proteinuria. The aim of this study was to evaluate the data of HSN patients who underwent renal biopsy, and compare the main clinical and laboratory parameters that may affect renal biopsy findings, treatment protocols, and short- and long-term outcome of those patients.MethodsBiopsies performed in 72 HSN patients between January 2007 to January 2017 were retrospectively evaluated. They were divided into two groups according to renal biopsy classification of the International Study of Kidney Disease in Children. Renal outcome, clinical and laboratory parameters, treatment protocols, and outcome were compared between groups. Short- and long-term follow-up of patients were evaluated.ResultsOf 72 patients, 47 were male (65.3%) and 44 (61.1%) were ≤10 years of age. Neutrophil-lymphocyte ratio was found higher in patients with scrotal involvement (p=0.042). Short-term unfavorable outcome was significantly higher in patients with scrotal involvement (p=0.038). Patients with hypertension and decreased creatinine clearance were found to have more unfavorable outcomes in long-term follow-up (p=0.029, p=0.040).ConclusionCyclosporin-A and cyclophosphamide could be effective in steroid unresponsive HSN patients. Patients with scrotal involvement, decreased creatinine clearance, and hypertension should be closely monitored for sequelae of HSN.
Highlights
Henoch-Schönlein purpura nephritis (HSN) is defined as Henoch-Schönlein purpura with kidney involvement, including hematuria and/or proteinuria
Age, gastrointestinal, joint and scrotal involvement, presence of hypertension, clinical presentation, short-term and long-term follow up, decreased creatinine clearance, Hemoglobin level (Hb) level, neutrophil/ lymphocyte ratio (NLR), white blood cells (WBC), meanplatelet volume (MPV), C-reactive protein (CRP), and immunoglobulin A (Ig A) levels together with patient outcome were compared between groups
Biopsy was performed in 75 patients with HSN
Summary
Henoch-Schönlein purpura nephritis (HSN) is defined as Henoch-Schönlein purpura with kidney involvement, including hematuria and/or proteinuria. Methods: Biopsies performed in 72 HSN patients between January 2007 to January 2017 were retrospectively evaluated They were divided into two groups according to renal biopsy classification of the International Study of Kidney Disease in Children. Henoch-Schönlein purpura (HSP) is the most common self-limiting vasculitis in childhood[1] This systemic leukocytoclastic angiitis mainly affects the small vessels of the skin, joints, gastrointestinal tract, and kidneys. Other organs such as brain, lungs, and scrotum could be involved during the disease[2]. Henoch-Schönlein nephritis (HSN) defined as HSP with kidney involvement, including hematuria and/or proteinuria, is the most serious complication and often determines the prognosis of the patient[7]
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