Long-term Results in Children with Henoch-Schönlein Nephritis

Objective: Henoch-Schönlein purpura (HSP) is a small vessel vasculitis and palpable purpura, with arthritis, gastrointestinal as abdominal pain, and renal involvement as typical clinical findings. The most important prognostic factor for HSP vasculitis is renal involvement. This study aimed to inves...

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Main Authors: Caner ASLAN, Nilufer GOKNAR, Emre KELESOGLU, Diana UCKARDES, Cengiz CANDAN
Format: Article
Language:English
Published: Galenos Publishing House 2022-06-01
Series:Medeniyet Medical Journal
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Online Access:https://jag.journalagent.com/z4/download_fulltext.asp?pdir=medeniyet&un=MEDJ-92331
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author Caner ASLAN
Nilufer GOKNAR
Emre KELESOGLU
Diana UCKARDES
Cengiz CANDAN
author_facet Caner ASLAN
Nilufer GOKNAR
Emre KELESOGLU
Diana UCKARDES
Cengiz CANDAN
author_sort Caner ASLAN
collection DOAJ
description Objective: Henoch-Schönlein purpura (HSP) is a small vessel vasculitis and palpable purpura, with arthritis, gastrointestinal as abdominal pain, and renal involvement as typical clinical findings. The most important prognostic factor for HSP vasculitis is renal involvement. This study aimed to investigate the relationship between clinical, laboratory, and histopathologic findings of children with HSP nephritis with long-term renal prognosis. Methods: This retrospective study included children with HSP nephritis between January 2010 and December 2019. Initial clinical presentation, laboratory findings, and kidney biopsy results were obtained, and treatment modalities were recorded and classified using the Meadow classification and grouped into mild and severe cases. Additionally, data at the last follow-up were analyzed and classified. Results: A total of 90 children (59 male) with a mean age of 8.8+-3.2 years were included. According to initial clinical findings, 18 children were in the Meadow's severe group. Fifteen (15/72) children in the mild group and all children in the severe group had undergone kidney biopsy. The severe group had higher histopathologic stages compared to the mild group (p=0.022). Immunosuppressive treatments were used in 44.4% of mild cases and 100% of severe cases (p<0.01). On follow-up, only four children (two in the mild group) had persistent proteinuria. Conclusions: Severe clinical findings in the initial presentation were related to more intensive immunosuppressive treatment. Additionally, renal histopathological stages were higher in the severe group. Long-term follow-up for proteinuria is mandatory for all children with HSP nephritis, even with mild initial clinical findings.
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spelling doaj-art-737b96e60de74955a9e817cca40e50b22025-01-30T07:13:15ZengGalenos Publishing HouseMedeniyet Medical Journal2149-20422149-46062022-06-0137215916410.4274/MMJ.galenos.2022.92331MEDJ-92331Long-term Results in Children with Henoch-Schönlein NephritisCaner ASLAN0Nilufer GOKNAR1Emre KELESOGLU2Diana UCKARDES3Cengiz CANDAN4Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Clinic of Pediatrics, Istanbul, TurkeyIstanbul Medeniyet University Faculty of Medicine; Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Clinic of Pediatric Nephrology, Istanbul, TurkeyIstanbul Medeniyet University Faculty of Medicine; Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Clinic of Pediatric Nephrology, Istanbul, TurkeyIstanbul Medeniyet University Faculty of Medicine; Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Clinic of Pediatric Nephrology, Istanbul, TurkeyIstanbul Medeniyet University Faculty of Medicine; Istanbul Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Clinic of Pediatric Nephrology, Istanbul, TurkeyObjective: Henoch-Schönlein purpura (HSP) is a small vessel vasculitis and palpable purpura, with arthritis, gastrointestinal as abdominal pain, and renal involvement as typical clinical findings. The most important prognostic factor for HSP vasculitis is renal involvement. This study aimed to investigate the relationship between clinical, laboratory, and histopathologic findings of children with HSP nephritis with long-term renal prognosis. Methods: This retrospective study included children with HSP nephritis between January 2010 and December 2019. Initial clinical presentation, laboratory findings, and kidney biopsy results were obtained, and treatment modalities were recorded and classified using the Meadow classification and grouped into mild and severe cases. Additionally, data at the last follow-up were analyzed and classified. Results: A total of 90 children (59 male) with a mean age of 8.8+-3.2 years were included. According to initial clinical findings, 18 children were in the Meadow's severe group. Fifteen (15/72) children in the mild group and all children in the severe group had undergone kidney biopsy. The severe group had higher histopathologic stages compared to the mild group (p=0.022). Immunosuppressive treatments were used in 44.4% of mild cases and 100% of severe cases (p<0.01). On follow-up, only four children (two in the mild group) had persistent proteinuria. Conclusions: Severe clinical findings in the initial presentation were related to more intensive immunosuppressive treatment. Additionally, renal histopathological stages were higher in the severe group. Long-term follow-up for proteinuria is mandatory for all children with HSP nephritis, even with mild initial clinical findings.https://jag.journalagent.com/z4/download_fulltext.asp?pdir=medeniyet&un=MEDJ-92331henoch-schönlein purpuraproteinuriachronic kidney disease
spellingShingle Caner ASLAN
Nilufer GOKNAR
Emre KELESOGLU
Diana UCKARDES
Cengiz CANDAN
Long-term Results in Children with Henoch-Schönlein Nephritis
Medeniyet Medical Journal
henoch-schönlein purpura
proteinuria
chronic kidney disease
title Long-term Results in Children with Henoch-Schönlein Nephritis
title_full Long-term Results in Children with Henoch-Schönlein Nephritis
title_fullStr Long-term Results in Children with Henoch-Schönlein Nephritis
title_full_unstemmed Long-term Results in Children with Henoch-Schönlein Nephritis
title_short Long-term Results in Children with Henoch-Schönlein Nephritis
title_sort long term results in children with henoch schonlein nephritis
topic henoch-schönlein purpura
proteinuria
chronic kidney disease
url https://jag.journalagent.com/z4/download_fulltext.asp?pdir=medeniyet&un=MEDJ-92331
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AT nilufergoknar longtermresultsinchildrenwithhenochschonleinnephritis
AT emrekelesoglu longtermresultsinchildrenwithhenochschonleinnephritis
AT dianauckardes longtermresultsinchildrenwithhenochschonleinnephritis
AT cengizcandan longtermresultsinchildrenwithhenochschonleinnephritis