Clinical characteristics, pathology, and prognosis of children with diffuse endocapillary proliferative Henoch-Schönlein purpura nephritis.
10.7499/j.issn.1008-8830.2303022
- Author:
Ting-Ting YIN
1
;
Xiao-Jie PENG
1
;
Rui FU
1
;
Ying WANG
;
Yan LYU
;
Yan-Qing DENG
;
Jia-Qi FU
;
Zhi-Hao ZHANG
Author Information
1. Department of Nephrology, Jiangxi Provincial Children's Hospital, Nanchang 330006, China.
- Publication Type:Journal Article
- Keywords:
Child;
Endocapillary hyperplasia;
Pathology;
Prognosis;
Purpura nephritis
- MeSH:
Male;
Female;
Humans;
Child;
Child, Preschool;
Hematuria;
IgA Vasculitis;
Retrospective Studies;
Prognosis;
Nephritis
- From:
Chinese Journal of Contemporary Pediatrics
2023;25(8):837-842
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To investigate the clinical characteristics, pathology, and prognosis of children with diffuse endocapillary proliferative Henoch-Schönlein purpura nephritis (DEP-HSPN).
METHODS:A retrospective analysis was performed on the clinical, pathological, and prognosis data of 44 children with DEP-HSPN and 765 children without DEP-HSPN. The children with DEP-HSPN were diagnosed by renal biopsy in Jiangxi Provincial Children's Hospital from January 2006 to December 2021.
RESULTS:Among the 809 children with purpura nephritis, 44 (5.4%) had DEP-HSPN, with a mean age of (8±3) years, and there were 29 boys (65.9%) and 15 girls (34.1%). Compared with the non-DEP-HSPN group, the DEP-HSPN group had a significantly shorter time from onset to renal biopsy and a significantly higher proportion of children with respiratory infection or gross hematuria, and most children had nephrotic syndrome. The DEP-HSPN group had significantly higher levels of 24-hour urinary protein, urinary protein grading, microscopic hematuria grading, serum creatinine, and blood urea nitrogen and significantly lower levels of serum albumin and complement C3 (P<0.05). The DEP-HSPN group had a higher pathological grading, with predominant deposition of IgA in the mesangial area and capillary loops, and higher activity scores in the modified semi-quantitative scoring system (P<0.05). The Kaplan-Meier survival analysis showed that there was no significant difference in the renal complete remission rate between the two groups (P>0.05).
CONCLUSIONS:Children with DEP-HSPN have a rapid onset, severe clinical manifestations and pathological grading, and high activity scores in the modified semi-quantitative scoring system. However, most of the children with DEP-HSPN have a good prognosis, with a comparable renal complete remission rate to the children without DEP-HSPN.
