[Henoch Schonlein nephrites in children: clinical features and outcome: about 34 cases]

To describe epidemiological, clinical, histological aspects, treatment and outcome of Henoch-Sch"nlein nephrits in children. A retrospective study was conducted on medical data of 34 patients with Henoch-Sch"nlein nephritis From January 1, 1996 to December 31, 2010 in the Pediatric Department of Charles Nicolle Hospital. Nephritis occured in 68,7%. The average patient age was 7 years 2 months and sex ratio was 0,6. Microscopic hematuria was noted in 23,5%, moderate proteinuria with or without hematuria was observed in 20,5%. Nephrotic syndrome was noted in 29,5%; nephritic syndrome was associated to nephritic syndrome in 23,5%. Isolated hypertension was noted in one patient. Follow-up was 2 years 6 months. Remission was noted in 26 cases [76,4%], minor urinary abnormalities in 7 cases [20,5%] and renal active disease in one case. Relapse was observed in 6 cases. Our study was characterized by the predominance of severe renal manifestations and low grade histological aspects as well as favourable outcome in most 90% of cases

[Predictive factors of severe henoch-schonlein nephritis in children: About 34 cases]

Henoch Schonlein Purpura is the most frequent vasculitis in children. Renal involvement is variable. Renal manifestations vary from isolated microscopic hematuria to the association on nephrotic syndrome to nephritic syndrome. To determine the predictors of severe Henoch - Schönlein nephritis. Retrospective study over 15 years [1996-2010] of 34 chidren, with henoch-schonlein nephritis. Renal involvement was determined in 68.7%. Mean age was 7.23 years [3-14 years]. Renal manifestations were variable. Moderate renal manifestations were noted in 15 cases. Microscopic hematuria was observed in 23.5% of cases and moderate proteinuria with or without hematuria is noted in 20.5% of cases. Severe nephritis was noted in 18 cases: nephrotic syndrome in 29.5% and nephrotic syndrome associated to nephritic syndrome in 23.5%. Hypertension without urinary anomalies was observed in one case. In univariate analysis, factor predictive of severe nephritis were: male sex, macroscopic hematuria, biologic inflammatory syndrome and leukocytosis. In multivariate analysis, only the leukocytosis was predictor of severity. In our study, only leukocytosis was predictor of severity in henoch-schönlein nephritis

Histopathological spectrum of childhood idiopathic steroid-resistant nephrotic syndrome in Tunisia

In children, renal biopsy is routinely required in the management of idiopathic steroid-resistant nephrotic syndrome particularly prior to starting nephrotoxic immunosuppressive agents. To investigate the correlations between the results of initial renal biopsy in Tunisian children with idiopathic steroid-resistant nephrotic syndrome and the subsequent response to cyclosporine-prednisolone combination. We conducted a retrospective study of children with idiopathic steroid-resistant nephrotic syndrome over the period 2002- 2009. Data on clinico-biological features, histological diagnosis and response to cyclosporine-prednisolone were collected. Thirty patients were enrolled, of whom 16 had focal segmental glomerulosclerosis, eight had minimal change disease and six had diffuse mesangial proliferation. Complete Remission was achieved in 15 patients [50%]. Nine patients [30%] went into partial remission. Only six patients presented no response [20%]. No statistically significant relationship between the different pathological types and the response to CsA-prednisone was found. In our study, two important facts were noted: 1] the predominant histopathological subtype was the focal segmental glomerulosclerosis; 2] a high remission rate was achieved in our patients using a combined cyclosporine-prednisolone treatment regimen. This response is not dependent on the histological type

[Renal amyloidosis during behcet's disease. study of one case]

Amyloidosis in Bethel's disease is rare and has a poor outcome. Report a new case. We report a case of a 38-year-old tunisian woman who presented with Behcet's disease and nephrotic syndrome. Renal biopsy showed amyloid deposition consistent with AA type. She had not any associated disease that might be an additional cause of secondary amyloidosis. She was treated by colchicine. After 3 years, proteinuria had disappeared and persisted negative 11 years after the diagnosis. A second renal biopsy showed the persistence of amyloidosis. As amyloidosis is one of the prognostic factors affecting survival in Behcet's disease, patients with this disease should be screened for amyloidosis. Administration of colchicine to these patients may be beneficial