title: The significance of tubulointerstitial lesions in childhood Henoch-Schönlein nephritis.
abstract: Little information is currently available on the development of tubulointerstitial lesions in children with Henoch-Schönlein nephritis (HSN). To identify the impact of the development of tubulointerstitial changes in HSN, we retrospectively analyzed renal biopsies obtained from children with HSN.
  
  
  
  Twenty-eight children with HSN from whom serial renal biopsies had been obtained before and after immunosuppressive therapy were enrolled in the study. The patients were divided into two groups according to the observed change in tubulointerstitial lesion development: group I (n = 15), with stable or improved tubulointerstitial lesions, and group II (n = 13), with worsened tubulointerstitial lesions. Group II patients had longer duration of proteinuria than group I patients (3.7 ± 3.7 years vs. 1.7 ± 1.7 years, p = 0.052).
  
  
  
  The change in serum albumin level was negatively correlated with the change in tubulointerstitial scores before and after treatment (γ = -0.444, p = 0.018). Group II patients showed a significant decrease in immunoglobulin G (IgG) and IgA deposits after treatment (p = 0.039 and 0.003, respectively), while group II patients did not (p = 0.458 and 0.506, respectively).
  
  
  
  Although the International Study of Kidney Disease in Children classification of HSN does not include tubulointerstitial lesions, they can progress during treatment and could have significant clinical implications in association with the duration of proteinuria.
authors.affiliation: Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea.|Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Beom Jin
authors.initials: BJ
authors.lastname: Lim
authors.affiliation: Department of Pediatrics, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, C.P.O. Box 8044, 120-752, South Korea.
authors.forename: Jae Il
authors.initials: JI
authors.lastname: Shin
authors.affiliation: Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Sung-Eun
authors.initials: SE
authors.lastname: Choi
authors.affiliation: Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Hyechang
authors.initials: H
authors.lastname: Rhim
authors.affiliation: Department of Pediatrics, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, C.P.O. Box 8044, 120-752, South Korea.
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, C.P.O. Box 8044, 120-752, South Korea.
authors.forename: Pyung Kil
authors.initials: PK
authors.lastname: Kim
authors.affiliation: Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea.
authors.forename: Hyeon Joo
authors.initials: HJ
authors.lastname: Jeong
authors.affiliation: Department of Pediatrics, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, C.P.O. Box 8044, 120-752, South Korea. kkkjhd@yuhs.ac.
authors.forename: Ji Hong
authors.initials: JH
authors.lastname: Kim
mesh_terms: D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011695:IgA Vasculitis / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology*; D007074:Immunoglobulin G / Q000276:immunology / Q000378:metabolism; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007668:Kidney / Q000473:pathology*; D008297:Male; D009395:Nephritis, Interstitial / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology*; D011507:Proteinuria / Q000652:urine; D012189:Retrospective Studies; D012709:Serum Albumin / Q000032:analysis
chemical_list: D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D012709:Serum Albumin
keywords: Henoch–Schönlein nephritis; duration of heavy proteinuria; mesangial IgA deposits; tubulointerstitial lesions