Comparison of clinical characteristics between diffused capillary endothelial proliferative Henoch-Sch?nlein purpura nephritis children with and without crescents formation / 中国医师进修杂志

ABSTRACT

Objective To investigate the clinical characteristics of diffused capillary endothelial proliferative Henoch-Sch?nlein purpura nephritis (DEP-HSPN) children with or without crescents formation. Methods The clinical data of 110 DEP-HSPN children diagnosed by renal biopsy from February 2013 to June 2017 in Shangluo Maternal and Child Health Family Planning Service Center were retrospectively analyzed. Among them, 24 cases had no crescents formation (group A), and 86 cases had crescents formation (group B). The children of 2 groups were treated with standard regimen, and the clinical characteristics and prognosis between 2 groups were compared. Results The rates of Ⅴ type and gross hematuria in group B were significantly higher than those in group A 59.3% (51/86) vs. 0 and 83.7% (72/86) vs. 29.2% (7/24), the levels of urine red blood cell count, 24 h urine protein and serum creatinine were significantly higher than those in group A (112.4 ± 20.3)/HP vs. (45.2 ± 10.6)/HP, (2 471.6 ± 242.0) mg vs. (1 358.5 ± 109.3) mg and (44.9 ± 9.6) μmol/L vs. (32.3 ± 5.2) μmol/L, the level of serum albumin was significantly lower than that in group A (22.8 ± 3.8) g/L vs. (35.1 ± 5.7) g/L, and there were statistical differences (P＜0.01 or ＜0.05). There were no statistical differences in rate of nephrogenous albuminuria, glomerular pathology type and immunoglobulin deposition condition between 2 groups (P＞0.05). There were 17 cases of complete remission and 7 cases of asymptomatic hematuria in group A, and 50 and 36 cases in group B, respectively. There was no significant difference between 2 groups (P > 0.05). Conclusions When DEP-HSPN is accompanied by crescent formation, gross hematuria, urine red blood cell count and the proportion of massive albuminuria can increase significantly. Combination therapy with immunosuppressive agents in acute stage and long- term sequential treatment could achieve good prognosis.