title: Successful treatment of progressive Henoch-Schönlein purpura nephritis with tonsillectomy and steroid pulse therapy.
abstract: 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.
authors: Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine and Dentistry.
authors: Hitoshi
authors: H
authors: Sugiyama
authors: Naomi
authors: N
authors: Watanabe
authors: Tetsuya
authors: T
authors: Onoda
authors: Yoko
authors: Y
authors: Kikumoto
authors: Miki
authors: M
authors: Yamamoto
authors: Manabu
authors: M
authors: Maeta
authors: Nobuya
authors: N
authors: Ohara
authors: Yohei
authors: Y
authors: Maeshima
authors: Yasushi
authors: Y
authors: Yamasaki
authors: Hirofumi
authors: H
authors: Makino
mesh_terms: 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
chemical_list: D005938:Glucocorticoids; D011241:Prednisone; D008775:Methylprednisolone