New Insights into the Pathogenesis of and Long-Term Risks in Children with Henoch-Schonlein Purpura Nephritis

2008 ◽  
Vol 4 (1) ◽  
pp. 58-65
Author(s):  
Lavjay Butani ◽  
Keith Lau
2007 ◽  
Vol 22 (10) ◽  
pp. 1717-1722 ◽  
Author(s):  
Mohan Shenoy ◽  
Mark G. Bradbury ◽  
Malcolm A. Lewis ◽  
Nicholas J. A. Webb

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Li Wu ◽  
Jianhua Mao ◽  
Xia Jin ◽  
Haidong Fu ◽  
Huijun Shen ◽  
...  

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.


2014 ◽  
Vol 104 (8) ◽  
pp. 843-848 ◽  
Author(s):  
Elena Tudorache ◽  
Christine Azema ◽  
Julien Hogan ◽  
Hala Wannous ◽  
Bilal Aoun ◽  
...  

Author(s):  
Eda Didem Kurt-Şükür ◽  
Thivya Sekar ◽  
Kjell Tullus

Abstract Background Knowledge on normal progress and treatment of Henoch-Schönlein purpura nephritis (HSPN) is limited. This study reviews outcome, clinical, pathological, and therapeutic factors affecting the prognosis of HSPN patients. Methods Forty-nine children with biopsy-confirmed HSPN diagnosed between September 2008 and 2018 were included. Demographics, clinical and laboratory data, treatment, and outcome were recorded at the time of biopsy, 3, 6, 12, and 24 months and at last visit. Clinical outcome was graded according to Meadow’s criteria. Results The median age at time of biopsy was 10.1 years (IQR:5.7) and female/male ratio 24/25. At presentation, 40.8% of patients had nonnephrotic proteinuria, 18.4% nephrotic syndrome (NS), 4.1% nephritic syndrome (NephrS), and 36.7% NephrS+NS. There were 11 patients with an estimated glomerular filtration rate below 90 ml/min/1.73 m2. Biopsy specimens were classified according to International Study of Kidney Diseases in Children (ISKDC) and Oxford Classification MEST-C scoring systems. Forty-one patients received angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, 37 patients steroids, and 35 patients other immunosuppressive medications. At last visit, 24 patients had stage 1 chronic kidney disease (CKD), three stage 2 CKD, and two had stage 5 CKD. Neither clinical parameters nor ISKDC biopsy grade or treatment modalities effected the final outcome. The Oxford classification showed significantly increased segmental glomerulosclerosis in patients with unfavorable outcome. Favorable outcome was associated with shorter time from kidney involvement to biopsy and start of treatment. Conclusion A large proportion of patients continued to show signs of CKD at last follow-up while only a small proportion developed stage 5 CKD.


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