Clinicopathological evaluation of Childhood Henoch-Schönlein Purpura(HSP) Nephritis with Nephrotic Syndrome

Kang, Hyeon-Ho; Yoon, Kyung-Leem; Cho, Byoung-Soo

J Korean Soc Pediatr Nephrol > Volume 4(2); 2000 > Article

J Korean Soc Pediatr Nephrol 2000;4(2): 111-119.

신증후군을 동반한 Henoch-Schönlein 신염 환아의 임상병리 적 고찰

강현호, 윤경림, 조병수

¹경희대학교 의과대학 소아과학교실
²경희대학교 의과대학 소아과학교실
³경희대학교 의과대학 소아과학교실

Clinicopathological evaluation of Childhood Henoch-Schönlein Purpura(HSP) Nephritis with Nephrotic Syndrome

Hyeon-Ho Kang, Kyung-Leem Yoon, Byoung-Soo Cho

¹Department of Pediatrics, College of Medicine, Kyung-Hee university
²Department of Pediatrics, College of Medicine, Kyung-Hee university
³Department of Pediatrics, College of Medicine, Kyung-Hee university

ABSTRACT

Purpose : Henoch-$Sch{ddot{o}}nlein$ purpura(HSP) is a common pediatric discase presenting most frequently with skin, gastrointestinal, joint and renal manifestations. The prognosis of HSP is mainly determined by the involvement of the kidney, but prognostic markers have not been established. We evaluated the patients who have HSP nephritis with nephrotic syndrome. Method : Clinical manifestations and laboratory findings were observed and analyzed in 34 cases with HSP which were manifested by nephrotic syndrome hospitalized at Kyung Hee university Hospital during the period from Jan. 1990 to Dec. 1998.
Results : 1) Male to female ratio was 1.3:1, and mean age at onset was 8.3 year. 2) Mean duration from symptom onset to renal biopsy was 10.5 weeks. 3) Proportion of patients presenting with acute nephritis was 32.4$%$, gross hematuria 17.6$%$, microscopic hematuria 50$%$. 4) The findings of renal biopsy were 20 cases of grade II, 11 cases of grade III, 2 cases of grade I, 1 case of grade IV according to classification by ISKDC. 5) Patients with grade I were recovered with no residual defect, but patients with grade IV shows active renal disease(states C).
Conclusion : Among the 디le patients with Henoch-$Sch{ddot{o}}nlein$ purpura accompanying nephrotic syndrome, more aggressive treatment might be needed in patients showing crescents formation on renal biopsy. A prospective study will be needed to explore the progression of this disease.

Key words: H-S purpura | nephrotic syndrome | renal biopsy | acute nephritis