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- Title
Successful therapy with tonsillectomy for severe ISKDC grade VI Henoch-Schönlein purpura nephritis and persistent nephrotic syndrome.
- Authors
Ohara, Shinichiro; Kawasaki, Yukihiko; Matsuura, Hiromi; Oikawa, Tomoko; Suyama, Kazuhide; Hosoya, Mitsuaki
- Abstract
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.
- Subjects
SCHOENLEIN-Henoch purpura; PEDIATRIC nephrology; TONSILLECTOMY; UROKINASE; PLASMAPHERESIS; NEPHROTIC syndrome in children; CHILD death
- Publication
Clinical & Experimental Nephrology, 2011, Vol 15, Issue 5, p749
- ISSN
1342-1751
- Publication type
Article
- DOI
10.1007/s10157-011-0463-8