Renal involment in patients with Schönlein-Henoch purpura

Abstract

Introduction and objectives. Nephropathy associated with Schönlein-Henoch purpura (HSP), now known as IgA vasculitis, is a glomerulonephritis that, when it appears, marks the prognosis and treatment of this disease. The aim of this study was to analyse renal involvement in children with a history of HSP followed in the paediatric nephrology department of a tertiary hospital.

Materials and methods. We designed a descriptive, cross-sectional, and retrospective study. The target population consists of children with a history of HSP and renal involvement who have been followed in the pediatric nephrology clinic of a tertiary hospital over the last 15 years. Medical records were reviewed, and a descriptive analysis was conducted using Excel software.

Results. The final sample consisted of 30 children, with a mean age at diagnosis of 7.13 years. 56.7% presented with transient urinary abnormalities (proteinuria and/or hematuria), while 43.3% had persistent abnormalities. Among the latter, 7 had mild involvement and 6 had moderate/severe involvement. Four biopsies were performed on three of the children. Regarding treatment, nephrotic syndrome patients did not respond to corticosteroids; one responded to cyclosporine and another to tacrolimus. The persistent proteinuria, which appeared one year after diagnosis, did not respond to ACE inhibitors or corticosteroids but did respond to cyclosporine.

Conclusions. Close follow-up of patients with HSP is important, as renal involvement, although generally mild, is variable and fluctuating and influences prognosis. We observed 20% moderate/severe renal involvement.