Clinical and pathological characteristics of childhood Henoch-Sch?nlein purpura nephritis with proteinuria

Objectives To explore the clinical features and pathological types of childhood Henoch- Sch?nlein purpura nephritis(HSPN)with proteinuria. Methods Clinical and pathological data of 180 children with HSPN presenting with proteinuria were retrospectively analyzed in groups according to 24-hour urinary protein levels. Results The moderate proteinuria(57 cases, 31.7%) was the most common clinical type, followed by high-grade proteinuria(51 cases, 28.3%), mild proteinuria(46 cases, 25.6%) and microalbuminuria(26 cases, 14.4%). According to the International Study of Kidney Disease of Children, the major pathological type of HSPN are grade II(92 cases, 51.1%) and grade III(73 cases, 40.6%). The main pathological changes of moderate proteinuria were grade II(31 cases, 54.4%), and the main pathological changes of high-grade proteinuria were grade III(33 case, 64.7%). The pathological grade was progressively increased along with severity of proteinuria. The difference was statistically significant(χ2=39.54, P=0.002). The main immunopathological type was IgA+IgM(84 cases, 46.7%), followed by IgA+IgM+IgG(55 cases, 30.6%). No correlation was found among immunopathological typing, pathological typing and clinical typing(P0.05). Conclusions The HSPN children with massive proteinuria show more severe pathological changes, but the severity of clinical symptoms is not completely consistent with the pathological damages.