Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 3-4, Pages: 174-178
https://doi.org/10.2298/SARH1104174S
Full text ( 186 KB)
Cited by
Henoch-Schönlein purpura outcome in children: A ten-year clinical study
Spasojević-Dimitrijeva Brankica (Odeljenje nefrologije, Univerzitetska dečja klinika, Beograd)
Kostić Mirjana (Odeljenje nefrologije, Univerzitetska dečja klinika, Beograd)
Peco-Antić Amira (Odeljenje nefrologije, Univerzitetska dečja klinika, Beograd)
Kruščić Divna (Odeljenje nefrologije, Univerzitetska dečja klinika, Beograd)
Cvetković Mirjana (Odeljenje nefrologije, Univerzitetska dečja klinika, Beograd)
Miloševski-Lomić Gordana (Odeljenje nefrologije, Univerzitetska dečja klinika, Beograd)
Paripović Dušan (Odeljenje nefrologije, Univerzitetska dečja klinika, Beograd)
Introduction. Henoch-Schönlein purpura (HSP) is the most common vasculitis of
childhood. It is characterized by symptoms including nonthrombocytopenic
purpura, abdominal pain, haematuria/proteinuria, and arthralgia/arthritis.
The pleiomorphism of clinical signs in HSP could be confused with other
conditions or other vasculitis forms. Objective. Evaluation of HSP clinical
presentation, the onset and severity of renal manifestation in affected
children and their outcome. Methods. A retrospective study of 49 patients
diagnosed with HSP was conducted from September 1999 to September 2009.
Children with severe renal manifestations (nephrotic range proteinuria, with
or without nephrotic or nephritic syndrome) have undergone kidney biopsy.
Results. Twenty-five patients developed renal manifestations after onset of
the disease. In our study child’s older age was a risk factor for association
with HSP nephritis. Six of the patients required kidney biopsy. They were
successfully treated with various immunosuppressive protocols, as well as
three of nine patients with nephrotic range proteinuria. Two patients
developed most severe form of HSP nephritis, nephrotic-nephritic syndrome
with histology grade IIIb/IVb. During the study period (average follow-up 6
years), all patients had a normal global renal function with mild proteinuria
in only two cases. The prognosis of renal involvement was better than reports
from other patient series. Conclusion. Long-term morbidity of HSP is
predominantly attributed to renal involvement. During the study period, no
patient had renal insufficiency or end stage renal disease after various
combinations of immunosuppressive treatment. It is recommended that patients
with HSP nephritis are followed for longer periods of time with a regular
measurement of renal function and proteinuria.
Keywords: Henoch-Schönlein purpura, nephritis, children
More data about this article available through SCIndeks