Successful treatment of adult-onset Henoch-Schönlein purpura nephritis with high-dose immunoglobulins.
A 26-year-old woman was admitted for the evaluation of edema and massive proteinuria. She had a history of purpura of the lower extremities, abdominal pain and melena. Laboratory investigations showed hypoalbuminemia, hypercholesterolemia and proteinuria of over 10 g/day. Renal biopsy showed moderate proliferative glomerulonephritis with mesangial immunoglobulin A (IgA) deposition. She was diagnosed as having Henoch-Schonlein purpura nephritis. Oral prednisolone, dipyridamole and intravenous heparin treatment were not effective. Steroid pulse therapy induced a partial improvement of proteinuria to 2-3 g/day. High-dose intravenous immunoglobulin (i.v.-IG) treatment was introduced and a dramatic improvement of proteinuria was noted. I.v.-IG should be fully considered in patients with steroid-resistant Henoch-Schonlein purpura nephritis.
Kusuda
A
A
First Department of Internal Medicine, Nagasaki University School of Medicine, Sakamoto.
Migita
K
K
Tsuboi
M
M
Degawa
M
M
Matsuoka
N
N
Tominaga
M
M
Kawakami
A
A
Kawabe
Y
Y
Taguchi
T
T
Eguchi
K
K
D000328:Adult; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications* / Q000188:drug therapy*; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D009404:Nephrotic Syndrome / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology
D016756:Immunoglobulins, Intravenous