Successful treatment of progressive Henoch-Schönlein purpura nephritis with tonsillectomy and steroid pulse therapy.
Henoch-Schönlein purpura (HSP) is a systemic disorder characterized by a leukocytoclastic vasculitis involving small vessels with the deposition of IgA immune complexes. The renal involvement is the major cause of morbidity and mortality in patients with HSP. We report here an adult patient with HSP nephritis (HSPN) accompanied by persistent proteinuria and progressive renal dysfunction despite conventional therapy. The patient was successfully treated with tonsillectomy followed by intravenous pulse methylprednisolone and oral prednisone. The combination therapy resulted in a significant decrease in proteinuria, improvement of renal function and the disappearance of microhematuria. The patient finally reached a stage of clinical remission.
Sugiyama
Hitoshi
H
Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine and Dentistry.
Watanabe
Naomi
N
Onoda
Tetsuya
T
Kikumoto
Yoko
Y
Yamamoto
Miki
M
Maeta
Manabu
M
Ohara
Nobuya
N
Maeshima
Yohei
Y
Yamasaki
Yasushi
Y
Makino
Hirofumi
H
D000328:Adult; D001706:Biopsy; D004333:Drug Administration Routes; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications / Q000473:pathology / Q000628:therapy*; D007668:Kidney / Q000473:pathology; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D009393:Nephritis / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D014066:Palatine Tonsil / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage*; D020551:Pulse Therapy, Drug; D014068:Tonsillectomy
D005938:Glucocorticoids; D011241:Prednisone; D008775:Methylprednisolone