Prognostic implications of normal or minimal urinary findings on long-term renal impairment in adults with Henoch-Schönlein purpura

Henoch-Schönlein purpura (HSP), also known as immunoglobulin A vasculitis, is a self-limiting, small vessel systemic vasculitis rarely found in adults characterized by palpable purpura, arthritis or arthralgia, gastrointestinal, and renal involvement. We report a case of a 31-year-old male with HSP complicated with severe gastrointestinal manifestations mimicking acute abdomen. He was successfully managed with conservative approach. Meticulous diagnosis, treatment, and long-term monitoring are important to reduce patient morbidity.

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P064 Henoch-Schonlein Purpura: experience of a general pediatric center

Rheumatology ◽

10.1093/rheumatology/keab722.056 ◽

2021 ◽

Vol 60 (Supplement_5) ◽

Author(s):

D J Belamri ◽

I Boustil ◽

S Zoubir ◽

Bensoltane H Chériet ◽

N Bouchair

Keyword(s):

Renal Failure ◽

Chronic Renal Failure ◽

Renal Involvement ◽

Winter Period ◽

Henoch Schonlein Purpura ◽

Severe Renal Failure ◽

Benign Condition ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura

Abstract Background Henoch-Schonlein purpura (HSP) is the most classic dysimmune vasculitis in children, related to an abnormal response of an immature immune system following an external antigen attack. Digestive involvement in HSP conditions the immediate vital prognosis and severe renal failure conditions the long-term functional prognosis. The Objective is to identify the epidemiological, clinical, disease course and therapeutic particularities of patients with HSP with a review of the literature. Material and method The authors reported the results of a retrospective study of cases of patients with HSP hospitalized and treated in the 02 pediatric departments of the wilaya of Annaba in Algeria (Clinique Sainte Thérèse, Annaba hospital university center and EHS El Bouni) over a period of 02 years. Information was obtained from hospital records. Results 24 cases of HSP were identified with a sex ratio of 1.4 (14 boys and 10 girls) and a hospital incidence of 1.66%. The average age was 6.6 years. Half of patients was hospitalized during the autumn-winter period, 67% of whom had an ENT infection before their hospitalizations. 17% of cases have personal history of HSP (the oldest was 5 years ago and the most recent 10 days before hospitalization). 7 patients underwent surgeries prior to hospitalization. Skin lesions were found in all patients. Joint, digestive and renal involvement were recorded in 50%, 80% and 25% respectively. Gastrointestinal bleeding has been observed in one patient. Only 1 patient with renal impairment progressed to chronic renal failure and only 1 patient had confirmed hypertension. A rare association with viral hepatitis A has been noted in one patient. Conclusion HSP remains a benign condition, easy to recognize clinically. Its immediate prognosis depends on the digestive complications and its long-term on nephropathy which may expose to the risk of chronic renal failure.

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Efficacy of Triptolide for Children with Moderately Severe Henoch-Schönlein Purpura Nephritis Presenting with Nephrotic Range Proteinuria: A Prospective and Controlled Study in China

BioMed Research International ◽

10.1155/2013/292865 ◽

2013 ◽

Vol 2013 ◽

pp. 1-5 ◽

Cited By ~ 11

Author(s):

Li Wu ◽

Jianhua Mao ◽

Xia Jin ◽

Haidong Fu ◽

Huijun Shen ◽

...

Keyword(s):

Treatment Group ◽

Control Group ◽

Henoch Schonlein Purpura ◽

Short Term ◽

Significant Difference ◽

Schonlein Purpura ◽

Nephrotic Range Proteinuria ◽

Henoch Schönlein Purpura ◽

Purpura Nephritis

Objective.To observe the clinical efficacy of the Chinese herb, Triptolide, in children with moderately severe Henoch-Schönlein purpura nephritis (HSPN).Methods. From January 2007 to December 2011, 56 HSPN children manifested by nephrotic range proteinuria with normal kidney function and<50% crescents or sclerosing lesions on biopsy were hospitalized in the Children’s Hospital of Zhejiang University School of Medicine. They were divided into two groups: the treatment group (Triptolide at a dosage of 1 mg/kg·d, combined with prednisone at a dosage of 2 mg/kg·d, within a course of medium-to-long-term therapy of 6 to 9 months) and the control group (; prednisone alone, with the same procedure).Results.Short-term remission was observed in 95% of patients from treatment group and in 72% of patients from control group, respectively. There was a significant difference between both groups () for short-term effects. Meanwhile, no significant difference, as proteinuria, hematuria, hypertension, and decreased eGFR, was observed between the two groups in long-term followup (). The Kaplan-Meier plot analysis also revealed no significant difference ().Conclusion.Triptolide is effective in relieving short-term symptoms for moderately severe HSPN children, though its long-term effects need to be observed further.

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