ESPN 53rd Annual Meeting

ESPN 2021

The Evaluation of Clinical, Laboratory and Pathologic Findings of Children with Henoch-Schönlein Nephritis and Investigating The Effect on Prognosis


 Background: Henoch-Schönlein Purpura (HSP) is the most common vasculitis seen in children. The most important prognostic factor for HSP vasculitis is the renal involvement. Our study is aiming to investigate the relation of clinical, laboratory and pathologic findings with long term prognosis.

Material and Methods: Children with HSP nephritis between January 2010 and December 2019 were included in this retrospective study. All children were classified with Meadow Classification according to initial and final clinical findings and grouped into mild and severe cases.

Results: Ninty children (59 male) with a mean age of 8.8±3.2 years were included. Nephritic syndrome, nephrotic syndrome and nephritic/nephrotic syndrome was present in 4%, 10% and 4% of the cases respectively. Seventy-two children (80%) were in mild group, eighteen were in severe group. Thirty-three children had undergone kidney biopsy; fifteen(15/72) were in mild group and eighteen(18/18) were in severe group. The indications were persistent proteinuria, nephrotic syndrome, nephritic/nephrotic syndrome, and decreased eGFR. We compared mild and severe group according to histopathologic findings and ISKDC stage 3B and more lesions were more frequently seen in children severe group(p=0.22). Immunosuppressive treatment were used in 44.4% in mild cases and 100% in severe cases(p<0.01). On follow up only four children (Two in mild group) had persistent proteinuria.

Conclusion: All children with severe clinical findings had undergone kidney biopsy and received immunosuppressive treatment. Clinical findings in initial assessment can help to predict histopathologic findings and treatment protocols in HSP nephritis. Persistent proteinuria on long term follow up can be seen even if children with mild clinical presentations. Long term follow up is required in all children with HSP nephritis.