Segura Torres P, Borrego Utiel F J, Pérez Del Barrio P, Ruiz Avila I
Nefrologia. 2007;27(1):96-8.
Henoch-Schönlein purpura is a systemic vasculitis that occurs most frequently in childhood. Massive proteinuria, renal impairement at onset and histologic severity in renal biopsy are considered the main risk factors for deterioration of renal function at long-term. We report a 24 years-old woman with Henoch-Schönlein purpura who developped a severe nephrotic syndrome with microhematuria and normal renal function. Renal biopsy showed a diffuse endocapillary proliferative glomerulonephritis with less than 50% crescents (type IIIB of ISKDC classification). As their potential bad prognosis we decided to treat with methyl-prednisolone pulses (3 x 500 mg in months 0, 3 and 5) accompanied by maintenance treatment with prednisone (0,5 mg/kg/every other day) for 9 months. We observed with this protocol complete remission of nephritis with preservation of renal function.
过敏性紫癜是一种最常发生于儿童期的系统性血管炎。大量蛋白尿、起病时的肾功能损害以及肾活检的组织学严重程度被认为是长期肾功能恶化的主要危险因素。我们报告一名24岁患有过敏性紫癜的女性,她发展为伴有镜下血尿且肾功能正常的严重肾病综合征。肾活检显示为弥漫性毛细血管内增生性肾小球肾炎,新月体少于50%(ISKDC分类的IIIB型)。鉴于其潜在的不良预后,我们决定采用甲泼尼龙冲击治疗(第0、3和5个月各3次,每次500mg),并联合泼尼松维持治疗(0.5mg/kg/隔日)9个月。通过该方案,我们观察到肾炎完全缓解且肾功能得以保留。