Clinical outcomes in children with Henoch–Schِnlein purpura nephritis grade IIIa or IIIb
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Yonghui Xia & Jianhua Mao & Yifang Chen & Dayan Wang & Lu Cao & Shenhua Yao & Haidong Fu & Lizhong Du & Ai’min Liu
- چاپ و سال / کشور: 2011
Description
Henoch.Schonlein purpura (HSP) is one of the most common causes of systemic vasculitis in children. The incidence of HSP nephritis (HSPN) among HSP patients has been reported to be 15.62%. Even so, what constitutes severe HSPN is controversial. In the study reported here, we retrospectively reviewed the clinical features and prognosis of 101 children with HSPN, ISKDC grade IIIa/ IIIb, from January 1992 to November 2008. Patients with isolated hematuria and/or proteinuria<50 mg/kg/day received triptolide alone, and those with nephrotic range proteinuria received a combination therapy of prednisone and triptolide. Nephrotic syndrome was the most common clinical manifestation (45.5%). There were no significant differences in the clinical features (ƒش2=2.756, P=0.252), the side effects related to treatment (ƒش2=2.259, P=0.894), prognosis between IIIa and IIIb (ƒش2=3.013, P=0.222), or prognosis in grade IIIa patients receiving triptolide alone or triptolide and prednisone (ƒش2=1.207, P=0.272) and grade IIIb patients (ƒش2=1.158, P=0.282). No significant difference in clinical manifestations and long-term prognosis of our HSPN patients with grade IIIa or grade IIIb were found, implying that our patients with International Study of Kidney Disease in Children (ISKDC) grade IIIb were not the most severe cases of HSPN. Our results may also suggest that treatment with steroid may not alter the clinical outcome of such grade IIIa or IIIb patients.
Pediatr Nephrol (2011) 26:1083–1088 DOI 10.1007/s00467-011-1834-9 Received: 19 November 2010 / Revised: 17 January 2011 / Accepted: 11 February 2011 / Published online: 9 March 2011
