Treatment Outcomes in Children with Henoch-Schönlein Nephritis.
The aim of the present study was to quantify the effects of treatment of children with Henoch-Schönlein nephritis (HSN) evaluated on the basis of kidney biopsy findings. Data were analyzed from 32 patients with HSN (mean age 9.3 ± 3.5 years, 19 with nephrotic syndrome/nephrotic proteinuria NS/NP, 13 with nephritic syndrome NphS), in whom the diagnosis was confirmed by kidney biopsy. Patients received immunosuppressive treatment (azathioprine or cyclophosphamide) and/or steroids and renoprotection according to a defined protocol. Patients were referred to a specific treatment protocol selected on the basis of clinical symptoms of nephropathy (NS/NP or NphS) and histopathological grade according to the WHO classification. Grade I-II changes were defined as mild HSN, and grade III-V WHO as severe HSN. The follow-up kidney biopsy was performed upon obtaining parental consent in 17 children. Following treatment, proteinuria resolved in 78 % children with mild HSN and 87 % children with severe HSN. In kidney biopsy, histological improvement was seen in 59 % children and no worsening in 35 %. We conclude that a flexible treatment protocol related to clinical symptoms and histological staging may contribute to a reduction of proteinuria and a delay in disease progression in children with HSN.
Department of Pediatrics and Nephrology, Medical University of Warsaw, 63A Żwirki i Wigury St, 02-091, Warsaw, Poland. wasiaczki@wp.pl.
Małgorzata
M
Mizerska-Wasiak
Department of Pathology, Medical University of Warsaw, Warsaw, Poland.
Jadwiga
J
Małdyk
Department of Laboratory Diagnostics and Clinical Immunology of Developmental Age, Medical University of Warsaw, 63A Żwirki i Wigury St, 02-091, Warsaw, Poland.
Urszula
U
Demkow
Department of Pediatrics and Nephrology, Medical University of Warsaw, 63A Żwirki i Wigury St, 02-091, Warsaw, Poland.
Maria
M
Roszkowska-Blaim
Department of Pediatrics and Nephrology, Medical University of Warsaw, 63A Żwirki i Wigury St, 02-091, Warsaw, Poland.
Małgorzata
M
Pańczyk-Tomaszewska
D000293:Adolescent; D001706:Biopsy; D001798:Blood Proteins / Q000032:analysis; D002648:Child; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000188:drug therapy* / Q000473:pathology; D007668:Kidney / Q000473:pathology; D008297:Male; D009393:Nephritis / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome
D001798:Blood Proteins
Children; Henoch-Schönlein nephritis; Immunosuppression; Kidney; Renal protection