title: Henoch-Schönlein purpura outcome in children: a ten-year clinical study.
abstract: BACKGROUND
  Henoch-Schönlein purpura (HSP) is the most common vasculitis of childhood. It is characterized by symptoms including nonthrombocytopenic purpura, abdominal pain, haematuria/proteinuria, and arthralgia/arthritis. The pleiomorphism of clinical signs in HSP could be confused with other conditions or other vasculitis forms.
  
  
  OBJECTIVE
  Evaluation of HSP clinical presentation, the onset and severity of renal manifestation in affected children and their outcome.
  
  
  METHODS
  A retrospective study of 49 patients diagnosed with HSP was conducted from September 1999 to September 2009. Children with severe renal manifestations (nephrotic range proteinuria, with or without nephrotic or nephritic syndrome) have undergone kidney biopsy.
  
  
  RESULTS
  Twenty-five patients developed renal manifestations after onset of the disease. In our study child's older age was a risk factor for association with HSP nephritis. Six of the patients required kidney biopsy. They were successfully treated with various immunosuppressive protocols, as well as three of nine patients with nephrotic range proteinuria. Two patients developed most severe form of HSP nephritis, nephrotic-nephritic syndrome with histology grade IIIb/IVb. During the study period (average followup 6 years), all patients had a normal global renal function with mild proteinuria in only two cases. The prognosis of renal involvement was better than reports from other patient series.
  
  
  CONCLUSIONS
  Long-term morbidity of HSP is predominantly attributed to renal involvement. During the study period, no patient had renal insufficiency or end stage renal disease after various combinations of immunosuppressive treatment. It is recommended that patients with HSP nephritis are followed for longer periods of time with a regular measurement of renal function and proteinuria.
authors: Nephrology Department, University Children's Hospital, Belgrade, Serbia. brankicaspasojevic@yahoo.com
authors: Brankica
authors: B
authors: Spasojević-Dimitrijeva
authors: Mirjana
authors: M
authors: Kostić
authors: Amira
authors: A
authors: Peco-Antić
authors: Divna
authors: D
authors: Kruscić
authors: Mirjana
authors: M
authors: Cvetković
authors: Gordana
authors: G
authors: Milosevski-Lomić
authors: Dusan
authors: D
authors: Paripović