A retrospective study of 42 children with IgA nephropathy was undertaken to clarify possible correlations between clinical and histological features, severity and known prognostic factors. The disease was graded in both pathological (class I-V) and clinical (class A-D) classifications. There were no differences in clinical and laboratory data when compared with respect to gross hematuria, but the number of cases with proteinuria more than 150 mg/day is significantly greater in those with gross hematuria than with microhematuria (p less than 0.01). All of the patients with microhematuria were included in pathologic classes I and II. The patients with proteinuria less than 1 g/day is skewed to pathologic classes I and II, in contrast to the patients with more than 3 g/day, to pathologic class IV. Serum IgA level was increased only in 35.7% at the time of biopsy, most of which cases complained of gross hematuria. Immunofluorescence studies showed predominant deposits of IgA in the mesangium in all cases, while capillary deposits were found in 7 cases. Among the 12 cases of pathologic class IV, half of them had capillary IgA and fibrinogen deposits.

Adolescent↗

PubMedDate not supplied

Rifampin therapy in Henoch-Schönlein purpura nephritis accompanied by nephrotic syndrome.

Treatment of Henoch-Schönlein purpura nephritis accompanied by nephrotic syndrome is still controversial, even though both corticosteroids and immunosuppressants have been used for therapy. Rifampin has been shown to induce the immunosuppressive effect in animal models due to the inhibition of protein synthesis by cells involved in the immune process. The effects of prednisone and rifampin in 7 children (group A) and prednisone and other immunosuppressants in 5 children (group B) are studied by evaluating the clinical states and morphologic changes by sequential biopsies following treatment. All cases in group A displayed no proteinuria 6.4 months (mean) after treatment, but in group B only 2 cases presented no proteinuria 20.5 months (mean) after treatment; the remaining cases had persistent proteinuria. Immunopathologically, 5 of 7 cases in group A showed decreasing intensity and extent of immune deposits, while only 1 of 5 cases in group B. This study suggests that rifampin may have a therapeutic role in the treatment of Henoch-Schönlein purpura nephritis, particularly with nephrotic syndrome. A longer period of study is needed to evaluate improvements in histopathologic findings.

Adolescent↗