Incidence of renal complications in Schönlein—Henoch purpura syndrome in dependence of an early administration of steriods

Abstract

Between 1976 and 1986, the authors treated 33 children with Schönlein-Henoch purpura (S-H purpura), with physiological urinary finding on admission. Twenty-three of them received prednisone already at the beginning of hospitalization, 10 were not given any prednisone at all. In patients with prednisone, nephropathy occurred only once (4.3%), in those without prednisone it occurred 5 times (50%), the incidence being thus significantly higher. Prednisone was administered in doses ranging between 1.0 and 2.5 mg/kg body mass/day, on an average for 21 days (first 10 days in the same dose, later in reduced doses). Since there is a general lack of data on the positive effect of steroids upon the prevention of nephropathies in S-H purpura, the authors recommend more thorough studies in the initial stage of the disease (before the development of nephropathies).

Effectiveness of early prednisone treatment in preventing the development of nephropathy in anaphylactoid purpura

“…AP = anaphylactoid purpura demonstrated in controlled trials [1], about 12 years ago we began a prospective study in AP patients without nephropathy. The preliminary positive results of this study were presented in 1980 [18] and confirmed in 1988 by Buchanec et al [5]. We now present our final results and conclusions.…”

Early treatment with oral immunosuppressants in severe proteinuric purpura nephritis

“…The difference in the prevalence of nephropathy between the two groups was statistically significant (P<0.001). Our results, first presented in 1980 by Mollica et al [9], were confirmed in 1988 by Buchanec et al [10] and in 1998 by Kaku et al [11]. In contrast, Saulsbury [12], in a retrospective study, remarked that early corticosteroid therapy did not prevent delayed nephritis in children with HSP, although Robson and Leung [13] agreed with our treatment strategy.…”

Treatment-based literature of Henoch–Schönlein purpura nephritis in childhood

“…Retrospective and prospective studies have reported on patients with HSP lacking clinical signs of nephropathy at admission who were treated with prednisone at doses ranging from 1.0 to 2.5 mg/kg per day over a period of 7-21 days. The authors of these preliminary studies concluded that compared to untreated patients, treated children displayed a lower incidence (Δ12-46%) of nephropathy [15][16][17]. A multivariate analysis demonstrated that oral prednisone or intravenous methylprednisolone (MP) prophylaxis (5 mg/kg four to six times per day for 3-5 days) significantly decreased the risk of renal involvement [3].…”