Clinical outcome of children with Henoch-Schönlein purpura nephritis.
OBJECTIVE
Evaluate the outcomes of pediatric patients with Henoch-Sch6nlein purpura nephritis andfind the parameters correlated with outcomes of treatment.


METHODS
Review of medical records was performed in twenty patients diagnosed with Henoch-Schinlein purpura nephritis. Demographic data, clinical parameters and records of treatment at diagnosis and the last visit were collected and analyzed.


RESULTS
Median age at diagnosis was 8-year-old and median follow-up time was 39 months. All patients had urine protein to creatinine ratio (UPCR) of more than 1.0 g/g while ten patients had hypoalbuminemia. Renal pathology results were class I, II, and III in 2, 14, and 4 patients respectively. Prednisolone was prescribed in all patients and cyclophosphamide was given in 13 patients. All patients had first resolution of proteinuria at median time of six months (range 2-47 months). At the last visit, 13 patients (65%) had remission of proteinuria (remission group), while seven patients (35%) became proteinuric relapse (relapse group) with UPCR > 0.2 g/g. Interestingly, the remission group had median time to first resolution of proteinuria shorter than the relapse group (6 months and 19 months, p < 0.001). Moreover, estimated glomerular filtration rate at diagnosis correlated negatively with UPCR at the last visit (r = -0.773, p = 0.001).


CONCLUSIONS
Pediatric patients with Henoch-Schönlein purpura nephritis who presented with heavy proteinuria had favorable outcome after treatment. The patients who had early resolution ofproteinuria remained in remission more than those who had late resolution.
Division of Nephrology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. rakpl@mahidol.ac.th
Kwanchai
K
Pirojsakul
Kanchana
K
Tangnararatchakit
Panas
P
Chalermsanyakorn
Wiwat
W
Tapaneya-Olarn
D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications*; D008297:Male; D009393:Nephritis / Q000188:drug therapy / Q000209:etiology*; D011239:Prednisolone / Q000627:therapeutic use; D011507:Proteinuria / Q000188:drug therapy / Q000209:etiology; D012074:Remission Induction; D012189:Retrospective Studies
D000893:Anti-Inflammatory Agents; D011239:Prednisolone; D003404:Creatinine