Clinical and pathological analysis of Henoch-Sch(o)nlein purpura nephritis in 279 children / 中国小儿急救医学

ABSTRACT

Objective To study the feature of clinical and pathological type of Henoch-Sch(o)nlein purpura nephritis (HSPN) in children.Methods Clinical and pathological data of HSPN in 279 children were collected and retrospectively analyzed.Results Clinical manifestation of HSPN in 279 children with haematuria and proteinuria (107 cases,38.4％) was the most common type,followed by nephritic syndrome type (69 cases,24.7％),isolated proteinuria type (40 cases,14.3％),isolated hematuria type (29 cases,10.4 ％),acute glomerulonephritis type (21 cases,9.3 ％),rapidly progressive glomerulonephritis type (8 cases,2.9％),chronic glomerulonephritis type (5 cases,1.8％).According to the International Study of Kidney Disease in Children,the majority renal pathological type of HSPN were grade Ⅱ (133 cases,47.7％)and grade Ⅲ (109 cases,39.1％).The pathological changes of hematuria and proteinuria type were mainly grade Ⅱ (61 cases,57.0％) and grade Ⅲ (35 cases,32.7％),and the pathological change of nephritic syndrome type was grade Ⅲ (41 cases,59.4％).All of renal pathological changes,38.7％ (108/279) had codeposition of immunoglobulins A and M,30.8％ (86/279) had co-deposition of immunoglobulins A,G and M.The pathological change of nephritic syndrome type was more serious (x2 =35.989,P ＜ 0.05).Immune complex deposition was not correlated with renal pathologic classification (P ＞ 0.05).Conclusion The HSPN patients mainly show the type of hematuria and proteinuria and the type of nephritic syndrome.The majority renal pathological type of HSPN are grade Ⅱ and grade Ⅲ.In children with HSPN,the severity of the clinic symptoms is not completely consistent with the pathological changes.The pathological changes of nephritic syndrome type are more serious.To improve theprognosis of HSPN,we should make the treatment planning according to the clinical types and pathologic classification.