The adult kidney 24 years after childhood Henoch-Schönlein purpura: a retrospective cohort study

Ronkainen, Jaana; Nuutinen, Matti; Koskimies, Olli

doi:10.1016/s0140-6736(02)09835-5

Cited by 269 publications

(225 citation statements)

References 15 publications

Supporting

Mentioning

185

Contrasting

Unclassified

Order By: Relevance

“…As an active lesion index, the scoring was estimated as follows: mesangial proliferation-normal (0), slight (1), moderate (2), severe (3); necrosis or cellular crescents-0% (0), 1-20% (1), 20-50% (2), >50% of glomeruli (3). The sum of these mesangial proliferation and necrosis or cellular crescents comprised the activity index.…”

Section: Renal Biopsymentioning

confidence: 99%

“…The sum of these mesangial proliferation and necrosis or cellular crescents comprised the activity index. The scoring of the chronicity index was estimated as follows: fibrous crescents or global sclerosis-0% (0), 1-20% (1), 20-50% (2), >50% of glomeruli (3); tubular atrophy associated with interstitial fibrosis-0% (0), 1-20% (1), 20-50% (2), >50% of cortical area (3). The sum of these fibrous crescents and global sclerosis comprised the chronicity index.…”

Section: Renal Biopsymentioning

confidence: 99%

“…Renal involvement occurs in 30-90% of HSP patients, and is mild and self-limiting with microscopic hematuria and minimal proteinuria in most cases [2]. The severity of renal symptoms at onset is known to be the best prognostic factor for HSP in children, with patients presenting with nephrotic-range proteinuria or severe nephritis having the highest risk of a long-term outcome [3][4][5]. However, to date, the management of severe Henoch-Schönlein nephritis (HSN) has remained controversial.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Cyclosporin A therapy for Henoch–Schönlein nephritis with nephrotic-range proteinuria

et al. 2010

View full text Add to dashboard Cite

To evaluate the therapeutic role of cyclosporin A (CyA) for the treatment of Henoch-Schönlein nephritis (HSN), 29 patients (18 boys, 11 girls) with nephrotic-range proteinuria were analyzed retrospectively. Mean age was 8.6 years (range 2.0-15.5 years) at diagnosis of Henoch-Schönlein purpura (HSP). All patients had developed the nephrotic-range proteinuria at a mean interval of 4.4 months (range 0-50.7 months) after the diagnosis of HSP. Mean duration of CyA treatment was 12.3 months (range 2.6-55.0 months). Mean follow-up times were 3.7 years (range 1.2-12.9 years) from the beginning of the CyA treatment. Steroids were tapered off and stopped gradually after initiation of CyA. All patients responded to the CyA treatment within a mean of 1.8 months (range 1 week to 3.5 months). Twenty-three patients achieved stable remission with mean follow-up duration of 3.2 years and 6 patients seemed to become CyA-dependent, since they developed proteinuria when the treatment was stopped. Renal function was preserved in all patients but one who developed end-stage renal disease after poor compliance with CyA. We concluded that CyA treatment for HSN showing nephrotic-range proteinuria is very effective and a safe method, although some patients become CyA-dependent.

show abstract

Section: Renal Biopsymentioning

confidence: 99%

Section: Renal Biopsymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cyclosporin A therapy for Henoch–Schönlein nephritis with nephrotic-range proteinuria

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Regarding the effect of pregnancy on renal involvement in HSP patients, one study showed irreversible deterioration of renal function, possibly due to hyperfiltration during pregnancy [16]. Therefore, renal function should be monitored during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Henoch Schönlein Purpura in Pregnancy: a Case with Uncomplicated Maternal and Neonatal Outcome

Tejada¹,

McCarey²,

Boehlen³

et al. 2015

Int. J. Gynecol. Obstet. & Neona. Care

View full text Add to dashboard Cite

Abstract:Introduction: Henoch-Schönlein Purpura (HSP) is a systemic IgA-mediated small-vessel vasculitis. It is primarily a childhood disease, rarely described in pregnancy. Pregnant women with HSP are at risk for hypertensive and hemorrhagic complications. Due to the rarity of the condition during pregnancy, there is no consensus about the preferred course of treatment but concerns regarding optimal management are ongoing.Case presentation: We report the case of an 18 year-old primigravida, with a 3-year history of HSP, who had an uneventful pregnancy and term delivery with epidural anesthesia. Conclusion:Due to the systemic nature of HSP, multidisciplinary management of pregnant HSP patients should be warranted to prevent complications.

show abstract

“…Apart from the HSP patients with pulmonary hemorrhage, former studies have shown HSP to be a predominantly pediatric disease affecting children between the ages of 4 and 7 years (prevalence of 70 per 100,000 in that age range) [4]. Other studies had already shown, however, that older HSP patients were prone to suffer from more severe disease [15,16]. Our case was no exception (75 years old, complicated with CKD), and the findings overall suggest that older HSP patients need careful observation to detect complications not only of renal insufficiency, but also pulmonary hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary hemorrhage associated with Henoch-Schöenlein purpura in an adult patient primary diagnosed of IgA nephropathy

et al. 2014

View full text Add to dashboard Cite

We describe a case of IgA nephropathy (IgAN) followed by pulmonary hemorrhage associated with Henoch-Schöenlein purpura (HSP) in an adult female. The patient had a history of renal insufficiency and persistent hematuria and proteinuria, without any extra-renal involvement. She was diagnosed with IgAN 7 years before the onset of HSP and had received immunosuppressive therapy for 6 years. One year after discontinuing oral prednisolone and mizoribine, she suffered a pulmonary hemorrhage. She presented with exacerbated urinary findings, and palpable purpura, resulting in the diagnosis of HSP. Intravenous pulse methylprednisolone followed by oral prednisolone (1 mg/kg/day) and a monthly intravenous cyclophosphamide pulse resolved the pulmonary hemorrhage. In a review of 36 HSP patients complicated with pulmonary hemorrhage, 27.8 % of the patients perished [Rajagopala et al.,1]. While the most efficient therapeutic strategies for these patients have yet to be determined, we speculate that an aggressive therapy of pulse methylprednisolone combined with immunosuppression agents is likely to bring about the best outcome in cases with pathological conditions similar to our patient's. On the other hand, discontinuance of immunosuppressive therapy might have resulted in the aggravation of the disease, hence we should examine patients carefully not to miss the cue.

show abstract

The adult kidney 24 years after childhood Henoch-Schönlein purpura: a retrospective cohort study

Cited by 269 publications

References 15 publications

Cyclosporin A therapy for Henoch–Schönlein nephritis with nephrotic-range proteinuria

Cyclosporin A therapy for Henoch–Schönlein nephritis with nephrotic-range proteinuria

Henoch Schönlein Purpura in Pregnancy: a Case with Uncomplicated Maternal and Neonatal Outcome

Pulmonary hemorrhage associated with Henoch-Schöenlein purpura in an adult patient primary diagnosed of IgA nephropathy

Contact Info

Product

Resources

About