Early weight gain and outcome in Henoch-Schönlein nephritis.
BACKGROUND
Intrauterine growth restriction seems to be a risk factor for an aggravated course of secondary renal diseases in children. Catch-up growth after birth may play a critical role. We tested if there is an association between an aggravated course of nephritis in Henoch-Schönlein Purpura (PSHN) and low birth weight or early weight gain during infancy.


METHODS
We retrospectively analysed the clinical course of 34 children with PSHN.


METHODS
Patients were sorted according their birth weight standard deviation score (SDS) in tertiles. Early weight gain was defined as gain of weight standard deviation score >0.67 between birth and 2 years of age.


RESULTS
Patients with higher birth weight needed Cyclophosphamide in a higher rate than low birth weight children. In the high weight gain group (SDS gain >0.67) 9 of the 11 patients compared to 7 of 22 patients in the low weight gain group (SDS gain <0.67) presented with arterial hypertension during the initial manifestation of PSH nephritis (p=0.01). Median systolic blood pressure SDS in the high weight gain group was 1.54 (-1.39-4.71) versus 0.29 (0.52-4.05) in the low weight gain group (p=0.008). Nevertheless, other clinical parameters during first manifestation and follow-up were not relevantly different.


CONCLUSIONS
In contrast to the data of children with idiopathic nephrotic syndrome or IgA nephropathy, this study does neither provide evidence for an association between low birth weight nor early weight gain and the later course of PSHN. Interestingly, early weight gain was associated with a higher systolic blood pressure during the initial manifestation of PSHN.
Plank
C
C
Department of Pediatrics, University Hospital Erlangen, Germany.
Vasilache
I
I
Dittrich
K
K
Dötsch
J
J
D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005317:Fetal Growth Retardation / Q000175:diagnosis*; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D006977:Hypertension, Renal / Q000175:diagnosis / Q000188:drug therapy; D011695:IgA Vasculitis / Q000175:diagnosis* / Q000188:drug therapy / Q000469:parasitology; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007223:Infant; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D007668:Kidney / Q000473:pathology; D007677:Kidney Function Tests; D008297:Male; D009393:Nephritis / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D015430:Weight Gain
D007166:Immunosuppressive Agents; D003520:Cyclophosphamide