Clinical Outcome of Children with Henoch-Schönlein
Purpura Nephritis
Kwanchai Pirojsakul MD*, Kanchana Tangnararatchakit MD*,
Panas Chalermsanyakorn MD**, Wiwat Tapaneya-Olarn MD*
Affiliation :
* Division of Nephrology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital,
Mahidol University, Bangkok, Thailand
** Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Objective : Evaluate the outcomes of pediatric patients with Henoch-Schönlein purpura nephritis and fi nd the parameters
correlated with outcomes of treatment.
Material and Method: Review of medical records was performed in twenty patients diagnosed with Henoch-Schönlein
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 fi rst 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 fi rst resolution
of proteinuria shorter than the relapse group (6 months and 19 months, p < 0.001). Moreover, estimated glomerular fi ltration
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 of proteinuria remained in remission more than those who
had late resolution.
Keywords : Henoch-Schönlein purpura, Outcome, Nephritis, Renal, Pediatric patients
All Articles
Download