Henoch-Schonlein nephritis: long-term prognosis of unselected patients.

Koskimies, Olli; Mır, Sevgı; Rapola, Juhani; Vilska, J.

doi:10.1136/adc.56.6.482

Cited by 143 publications

(93 citation statements)

References 3 publications

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“…The uncommon occurrence of severe renal involvement in this population notwithstanding, the incidence of ESRD in HSP patients is highly variable according to the severity of the disease and follow-up periods. For unselected patients with HSP, the risk of ESRD is reportedly very low, at 1.5%; however, the studies have been limited by the relatively short mean follow-up of 7 to 8 years [10]. In contrast, a study from the UK with a significantly longer mean followup of 23.4 years showed a much higher rate of progressive renal insufficiency, approaching 20% [11].…”

Section: Discussionmentioning

confidence: 85%

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

et al. 2010

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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.

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Section: Discussionmentioning

confidence: 85%

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

et al. 2010

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“…In one study using a cohort of adult patients in whom the diagnosis was based on the findings of the characteristic leucocytoclastic skin vasculitis accompanied by IgA deposits (13), 49% of patients presented with abnormal urinary signs. In selected series, HSPN leads to chronic kidney disease (CKD) 20 years after the diagnosis in up to 20% of children (14), whereas this percentage falls to less than 5% in unselected series (15). The risk of CKD in adults is higher.…”

Section: Introductionmentioning

confidence: 99%

Henoch-Schönlein Purpura Nephritis

Davin¹

2011

Clinical Journal of the American Society of Nephrology

149

123

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SummaryHenoch-Schö nlein purpura nephritis is a rare kidney disease leading to chronic kidney disease in a non-negligible percentage of patients. Although retrospective studies suggest beneficial effects of some therapies, prospective randomized clinical trials proving treatment efficacy are still lacking. The dilemma of spontaneous recovery even in patients with severe clinical and histologic presentation and of late evolution to chronic kidney disease in patients with mild initial symptoms renders it difficult for clinicians to expose patients to treatment protocols that are not evidence-based. A better understanding of the pathophysiology of progression to chronic kidney disease in Henoch-Schö nlein purpura patients could be achieved by designing prospective international multicenter studies looking at determinants of clinical and histopathological evolution as well as possible circulating and urinary markers of progression. Such studies should be supported by a database available on the web and a new histologic classification of kidney lesions. This paper reports clinical, pathologic, and experimental data to be used for this strategy and to assist clinicians and clinical trial designers to reach therapeutic decisions.

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“…Jenis kelamin lebih banyak pada anak perempuan dibanding anak laki-laki (4:1), perbandingan ini tidak jauh berbeda dengan penelitianpenelitian yang telah dilapokan sebelumnya. 2,4,5 Melihat kecenderungan peningkatan insiden ini dicoba ditelusuri faktor mana yang lebih dominan dari beberapa faktor penyebab terjadinya penyakit ini. Beberapa faktor yang berperan yaitu genetik, lingkungan, infeksi, dan reaksi autoimun yang diperantarai imunoglobulin A. Kompleks antigen terdeposit di seluruh tubuh menjadi pencetus vaskulitis nekrotikans.…”

Section: Pembahasanunclassified

“…Gejala klinis yang telah dilaporkan dan yang kami temukan adalah purpura, nyeri sendi, nyeri perut, gangguan ginjal, leukositosis dan trombosis. 2,5 Gejala klinis yang timbul sudah tampak sangat jelas dan tampak berat mengingat sebagian besar subjek penelitian datang berobat ke Poliklinik Anak Rumah Sakit Dr. Cipto Mangunkusumo Jakarta setelah minggu pertama perjalanan penyakit. Penyebab pasien datang terlambat berobat diperkirakan berhudatang terlambat berobat diperkirakan berhubungan dengan tingkat ekonomi dan pengetahuan masyarakat yang rendah.…”

Section: Pembahasanunclassified

Pemberian Steroid pada Purpura Henoch-Schonlein serta Pola Perbaikan Klinis di Departemen Ilmu Kesehatan Anak FKUI/RSCM Jakarta

Safri

Kurniati²,

Munasir³

2016

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Hasil. Didapatkan 10 kasus baru dengan usia rerata 5 tahun 4 bulan. Perbandingan laki-laki dan perempuan 1:4. Seluruh subjek mempunyai gejala purpura dan nyeri sendi. Nyeri perut didapatkan pada 9 subjek, keterlibatan ginjal 3, hipertensi dan hematuria 1, proteinuria 3, leukositosis dan trombosis pada 6 dan 3 subjek. Tujuh subjek mendapat imunomodulator. Perbaikan gejala berupa purpura, nyeri perut, nyeri sendi dan nefritis terjadi setelah 2 minggu, sisanya sebelum 2 minggu. Leukositosis dan trombosis membaik setelah 1-2 minggu. Tujuh subjek mendapat steroid setelah 1 minggu timbul gejala, 3 subjek mendapat triamsinolon dan sisanya metil prednisolon. Nyeri perut paling cepat menghilang pada subjek yang mendapat triamsinolon, sedangkan purpura pada yang mendapat metil prednisolon.

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Henoch-Schonlein nephritis: long-term prognosis of unselected patients.

Cited by 143 publications

References 3 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 Nephritis

Pemberian Steroid pada Purpura Henoch-Schonlein serta Pola Perbaikan Klinis di Departemen Ilmu Kesehatan Anak FKUI/RSCM Jakarta

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