Successful therapy with tonsillectomy for severe ISKDC grade VI Henoch–Schönlein purpura nephritis and persistent nephrotic syndrome

Henoch–Schönlein purpura (HSP) is a systemic disorder characterized by leukocytoclastic vasculitis involving the capillaries and the deposition of IgA immune complexes. Renal involvement is the principal cause of morbidity and mortality in children with HSP. We report here a 13-year-old girl with He...

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Bibliographic Details
Published in:Clinical and experimental nephrology 2011-10, Vol.15 (5), p.749-753
Main Authors: Ohara, Shinichiro, Kawasaki, Yukihiko, Matsuura, Hiromi, Oikawa, Tomoko, Suyama, Kazuhide, Hosoya, Mitsuaki
Format: Article
Language:English
Subjects:
Adolescent
Case Report
Female
Humans
Medicine
Medicine & Public Health
Methylprednisolone - administration & dosage
Nephritis - drug therapy
Nephritis - surgery
Nephrology
Nephrotic Syndrome - drug therapy
Nephrotic Syndrome - surgery
Plasmapheresis
Proteinuria - drug therapy
Proteinuria - surgery
Pulse Therapy, Drug
Purpura, Schoenlein-Henoch - drug therapy
Purpura, Schoenlein-Henoch - surgery
Tonsillectomy
Treatment Outcome
Urokinase-Type Plasminogen Activator - administration & dosage
Urology
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Summary:Henoch–Schönlein purpura (HSP) is a systemic disorder characterized by leukocytoclastic vasculitis involving the capillaries and the deposition of IgA immune complexes. Renal involvement is the principal cause of morbidity and mortality in children with HSP. We report here a 13-year-old girl with Henoch–Schönlein purpura nephritis (HSPN) of International Study of Kidney Disease in Children (ISKDC) grade VI and persistent nephrotic syndrome despite receiving conventional therapy, such as prednisolone, methylprednisolone and urokinase pulse therapy and plasmapheresis (PP). The patient was treated with tonsillectomy, which subsequently decreased proteinuria, induced the disappearance of microscopic hematuria, and improved renal pathological findings. A regimen of methylprednisolone and urokinase pulse therapy plus PP with tonsillectomy may be an effective and useful therapy for some children with severe HSPN children of ISKDC grade VI and persistent nephrotic syndrome.
ISSN:1342-1751
1437-7799
DOI:10.1007/s10157-011-0463-8