Clinical and pathological analysis of Henoch-Schnlein purpura nephritis in 55 children

Objective To explore clinical,pathological features of Henoch-Schnlein purpura nephritis(HSPN) and their relationship in children.To provide references for the treatment and improve the life quality of the patients.Methods A total of 55 patients with HSPN were admitted to hospital from January 2000 to October 2008.The clinical and pathological data were retrospectively collected,grouped according to different conditions and analyzed.Results Hematuria and proteinuria was the most common clinical type with 22 cases(40.0%),followed by nephrotic syndrome with 16 cases(29.1%),while simple hematuria or proteinuria,acute glome rulonephritis and rapidly progressive glomerulone phritis were 6 cases(10.9%),4 cases(7.3%) and 1 case(1.8%) respectively.The percentage of nephrotic level porteinuia in cases with gastrointestinal symptoms was higher than that in cases without gastrointestinal symptoms(P 0.05).The percentage of nephrotic syndrome in cases with gross hemaururia was higher than that in cases with microscopic hemaururia(P 0.05).According to the standard of ISKDC,the majority of pathological changes of HSPN were grade Ⅱ with 27 cases(49.1%) and grade Ⅲ with 17 cases(29.1%).The percentage of deposition of IgA + IgG + IgM was 32 cases(58.2%) while 41 cases(74.6%) had C3 deposition;their pathological changes were mainly above Grade Ⅲ.Immune complex deposition and C3 deposition were associated with pathologic classification(P 0.05).Simple hematuria or peoteinuria had mild pathological changes with 7 cases(58.3%) of Grade Ⅱ.The pathological changes of hematuria and proteinuria type were mainly Grade II and Ⅲ with 12 cases(54.5%) and Grade Ⅲ with 5 cases(22.7%).The majority of the pathological changes of nephrotic syndrome type were above Grade Ⅲ with 6 cases(37.5%).Conclusions The HSPN patients mainly show the type of hematuria and proteinuria and the type of nephrotic syndrome.The majority of pathological changes of HSPN are grade Ⅱ and Ⅲ.Immune complex deposition and C3 deposition are associated with pathologic classification.In children with HSPN,clinical manifestation was consistent with pathological classification.Proteinuria is tending to become more severe when the gastrointestinal symptoms were prevalent and the extent of damage is severe.Gross hematuria has close relationship with the extent of renal injury.