Correlation between Clinicomorphologic Findings and Clinical Outcome in Childhood Henoch-Schonlein Purpura Nephritis

ABSTRACT

PURPOSE: Henoch-Schonlein purpura(HSP) is usually a self-limited disease with a good eventual outcome. The prognosis of HSP is mainly determined by the renal involvement. In this study, We evaluated children with biopsy-proven Henoch-Schonlein purpura nephritis about the clinical outcome correlated with renal manifestation and morphologic findings. METHODS: The clinical features, initial laboratory and pathologic findings, and clinical outcome were evaluated in 60 children with biopsy-proven Henoch-Schonlein purpura nephritis at Yonsei University Severance Hospital during the period from Jan. 1990 to Dec. 2002. RESULTS: The ratio of male to female patients was 1.2:1. The interval between the onset of Henoch-Schonlein purpura and renal manifestation was less than 3 months in 81% of the patients. Initial renal manifestation was microscopic hematuria in 100% of patients, isolated hematuria in 15%, acute nephritic syndrome in 7%, nephrotic syndrome in 22% of patients. Renal manifestation correlated with clinical outcome. Grade II and III were the most common in histologic grades of ISKDC. Renal pathologic finding correlated with clinical outcome. CONCLUSION: Renal manifestation and pathologic findings correlated with the clinical outcome. It is necessary to evaluate the correlation between pathologic findings and treatment.