In:
Nephron Extra, S. Karger AG, Vol. 1, No. 1 ( 2011-10-14), p. 101-111
Abstract:
〈 i 〉 Background: 〈 /i 〉 There is no clear consensus as to which patients with Henoch-Schönlein purpura nephritis (HSPN) at risk of a poor outcome should be treated and what therapeutic regimen should be used. 〈 i 〉 Methods: 〈 /i 〉 Nine children with heavy proteinuric HSPN received prompt initiation of methylprednisolone pulse therapy (MPT) combined with tonsillectomy in a prospective study. 〈 i 〉 Results: 〈 /i 〉 At presentation, the mean values for the patients’ urine protein excretion (early-morning urinary protein/creatinine ratio), serum IgA, activity index (AI), and chronicity index (CI) were 5.0 ± 5.6 g/g Cr, 135.6 ± 56.5 mg/dl, 4.0 ± 0.7, and 1.7 ± 1.3, respectively. At the second biopsy, conducted approximately 24 months after initiation of therapy, the patients’ serum albumin had significantly increased (4.4 ± 0.2, p 〈 0.01), and the serum IgA and AI had significantly decreased (88.1 ± 30.8 mg/dl, p 〈 0.05; 2.0 ± 1.2, p 〈 0.01, respectively), whereas the CI remained unchanged. Proteinuria disappeared within 24 months in all but 1 patient, and hematuria disappeared within 38 months in all patients. No patient showed renal impairment or experienced a recurrence and/or exacerbation of HSP/HSPN. 〈 i 〉 Conclusions: 〈 /i 〉 Early treatment with MPT combined with tonsillectomy is effective in ameliorating the histopathological progression and improving the clinical course of children with heavy proteinuric HSPN.
Type of Medium:
Online Resource
ISSN:
1664-5529
Language:
English
Publisher:
S. Karger AG
Publication Date:
2011
detail.hit.zdb_id:
2658188-7
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