Factors affecting histological regression of crescentic Henoch-Schönlein nephritis in children.
To identify the factors affecting histological regression of crescentic Henoch-Schönlein nephritis (HSN), we retrospectively analyzed serially biopsied 20 children with crescentic HSN treated with immunosuppressants. They were classified into two groups according to the histological changes between the first and second biopsy: group I (n=10) with histological regression and group II (n=10) with no change or histological progression. Of the 20 patients, 19 showed a favorable outcome at the end of follow-up. Initial laboratory and histological findings did not differ between the two groups. Histological regression was associated with a younger age at onset (P=0.003), early treatment with immunosuppressants (P=0.044) and absent or decreased fibrinogen deposits at the second biopsy (P<0.0001) in a univariate analysis. Mesangial IgA and fibrinogen depositions at the second biopsy were reduced significantly in group I (P<0.05). In the multivariate analysis, a younger age was an independent determinant of histological regression (OR 1.44; 95% CI 1.03-2.02). The intensity of fibrinogen deposits at the second biopsy correlated positively with the age at onset (r=0.503, P=0.024), and the chronicity index at the second biopsy correlated positively with the time that immunosuppressive therapy was started (r=0.619, P=0.004).
Shin
Jae Il
JI
The Institute of Kidney Disease, Department of Pediatric Nephrology, Yonsei University College of Medicine, Seoul, Korea.
Park
Jee Min
JM
Kim
Ji Hong
JH
Lee
Jae Seung
JS
Jeong
Hyeon Joo
HJ
D001706:Biopsy; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D009393:Nephritis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D012074:Remission Induction; D012189:Retrospective Studies
D007166:Immunosuppressive Agents