Clinical remission of Henoch-Schönlein purpura nephritis after a monotherapeutic tonsillectomy.
We herein describe an adult male patient who presented with tonsillitis, purpura, hematuria, and proteinuria. The serological analyses revealed elevated serum antistreptolysin, and the throat culture yielded Lancefield group A β-hemolytic streptococci. A renal biopsy revealed mild mesangial proliferation associated with granular mesangial depositions of IgA and C3, consistent with Henoch-Schönlein purpura nephritis (HSPN). Initially, the patient was treated with dipyridamole, which was followed by limited improvements in the proteinuria and hematuria. Nine months later, the tonsillitis relapsed due to GAS infection and deteriorated urinary abnormalities were noticed, which finally disappeared after monotherapeutic tonsillectomy. Although the impact of tonsillectomy on the treatment of HSPN remains to be characterized, our observations suggest that tonsillectomy in the present patient played a pivotal role in facilitating the recovery of the renal injuries. Because the arbitrary application of a tonsillectomy appears to be accompanied by ethical concerns, the evaluation of the clinical benefits of this procedure should be addressed more directly in the future.
Iwazu
Yoshitaka
Y
Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan.
Akimoto
Tetsu
T
Muto
Shigeaki
S
Kusano
Eiji
E
D000328:Adult; D005922:Glomerulonephritis, IGA / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications* / Q000473:pathology / Q000601:surgery*; D008297:Male; D014068:Tonsillectomy
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