A 26-year-old womanwas admitted for the evaluation of edema and massive proteinuria.She had a history of purpura of the lower extremities, abdominal pain and melena. Laboratory investigations showed hypoalbuminemia, hypercholesterolemia and proteinuria of over 10 g/day. Renal biopsy showed moderate proliferative glomerulonephritis with mesangial immunoglobulin A (IgA) deposition. She was diagnosed as having Henoch-Schonlein purpura nephritis. Oral prednisolone, dipyridamole and intravenous heparin treatment were not effective. Steroid pulse therapy induced a partial improvement of proteinuria to 2-3 g/day. High-dose intravenous immunoglobulin (IV-IG) treatment was introduced and a dramatic improvement of proteinuria was noted. IV-IG should be fully considered in patients with steroid-resistant Henoch-Schonlein purpura nephritis. (Internal Medicine 38: 376-379, 1999)
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