title: Henoch-Schönlein purpura nephritis and IgA nephropathy: a comparative clinical study.
abstract: OBJECTIVE
  Henoch-Schönlein purpura nephritis (HSPN) and IgA nephropathy (IgAN) are related syndromes. In the present study we aimed to compare the clinical characteristics and outcome of a large and unselected series of patients diagnosed as having HSPN and IgAN.
  
  
  METHODS
  Comparative study of a wide and unselected population of HSPN (142 patient) and IgAN (61 patients) from a teaching hospital of Northern Spain.
  
  
  RESULTS
  All of the following comparisons were expressed between HSPN vs. IgAN, respectively. HSPN patients were younger (30.6±26.4 vs. 37.1±16.5 years, p<0.001). Precipitating events, usually an upper respiratory tract infection and/or drug intake, were more frequently observed in HSPN (38% vs. 23%, p=0.03). Extra-renal manifestations were also more common in HSPN than in IgAN; skin lesions (100% vs. 1.8%; p<0.001), gastrointestinal (62% vs. 7.4%; p<0.001), and joint involvement (61.3% vs. 3.6%; p<0.001). However, nephritis was less severe in HSPN, renal insufficiency (25% in HSPN vs. 63.4% in IgAN; p<0.001), nephrotic syndrome (12.5%, vs. 43.7%; p<0.001), and nephritic syndrome (6.8% vs. 10.7%; NS). Leukocytosis was more frequent in HSPN (22.5% vs. 8.2%; p=0.015) and anaemia in IgAN (12.7% in HSPN vs. 36% in IgAN, p<0.001). The frequency of corticosteroid (79.6% vs. 69%; NS) and cytotoxic drug (19% vs. 16.5%, NS) use was similar. The frequency of relapses was similar (38.6% in HSPN vs. 36.3% in IgAN). After a median follow-up of 120.8 (IQR; 110-132) months in HSPN and 138.6 (IQR; 117-156) in IgAN, requirement for dialysis (2.9% vs. 43.5%; p<0.001), renal transplant (0% vs. 36%, p<0.001) and residual chronic renal insufficiency (4.9% vs. 63.8%; p<0.001) was more frequently observed in patients with in IgAN.
  
  
  CONCLUSIONS
  HSPN and IgAN represent different syndromes. IgAN has more severe renal involvement while HSPN is associated with more extra-renal manifestations.
authors.affiliation: Division of Rheumatology, Hospital Universitario Marqués de Valdecilla, IFIMAV, Santander, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Calvo-Río
authors.forename: J
authors.initials: J
authors.lastname: Loricera
authors.forename: L
authors.initials: L
authors.lastname: Martín
authors.forename: F
authors.initials: F
authors.lastname: Ortiz-Sanjuán
authors.forename: L
authors.initials: L
authors.lastname: Alvarez
authors.forename: M C
authors.initials: MC
authors.lastname: González-Vela
authors.forename: D
authors.initials: D
authors.lastname: González-Lamuño
authors.forename: C
authors.initials: C
authors.lastname: Mata
authors.forename: P
authors.initials: P
authors.lastname: Gortázar
authors.forename: J
authors.initials: J
authors.lastname: Rueda-Gotor
authors.forename: M
authors.initials: M
authors.lastname: Arias
authors.forename: E
authors.initials: E
authors.lastname: Peiró
authors.forename: V M
authors.initials: VM
authors.lastname: Martínez-Taboada
authors.forename: M A
authors.initials: MA
authors.lastname: González-Gay
authors.forename: R
authors.initials: R
authors.lastname: Blanco
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005455:Fluorescent Antibody Technique; D005922:Glomerulonephritis, IGA / Q000150:complications* / Q000276:immunology / Q000628:therapy; D006784:Hospitals, Teaching; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications* / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000276:immunology / Q000473:pathology*; D016030:Kidney Transplantation; D008875:Middle Aged; D009393:Nephritis / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000628:therapy; D011237:Predictive Value of Tests; D012074:Remission Induction; D006435:Renal Dialysis; D012189:Retrospective Studies; D013030:Spain; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D007166:Immunosuppressive Agents