Pirojsakul Kwanchai, Tangnararatchakit Kanchana, Chalermsanyakorn Panas, Tapaneya-Olarn Wiwat
Division of Nephrology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
J Med Assoc Thai. 2012 Jul;95(7):878-83.
Evaluate the outcomes of pediatric patients with Henoch-Sch6nlein purpura nephritis andfind the parameters correlated with outcomes of treatment.
Review of medical records was performed in twenty patients diagnosed with Henoch-Schinlein purpura nephritis. Demographic data, clinical parameters and records of treatment at diagnosis and the last visit were collected and analyzed.
Median age at diagnosis was 8-year-old and median follow-up time was 39 months. All patients had urine protein to creatinine ratio (UPCR) of more than 1.0 g/g while ten patients had hypoalbuminemia. Renal pathology results were class I, II, and III in 2, 14, and 4 patients respectively. Prednisolone was prescribed in all patients and cyclophosphamide was given in 13 patients. All patients had first resolution of proteinuria at median time of six months (range 2-47 months). At the last visit, 13 patients (65%) had remission of proteinuria (remission group), while seven patients (35%) became proteinuric relapse (relapse group) with UPCR > 0.2 g/g. Interestingly, the remission group had median time to first resolution of proteinuria shorter than the relapse group (6 months and 19 months, p < 0.001). Moreover, estimated glomerular filtration rate at diagnosis correlated negatively with UPCR at the last visit (r = -0.773, p = 0.001).
Pediatric patients with Henoch-Schönlein purpura nephritis who presented with heavy proteinuria had favorable outcome after treatment. The patients who had early resolution ofproteinuria remained in remission more than those who had late resolution.
评估小儿过敏性紫癜性肾炎患者的治疗结果，并找出与治疗结果相关的参数。
对20例诊断为过敏性紫癜性肾炎的患者病历进行回顾。收集并分析人口统计学数据、临床参数以及诊断时和末次随访时的治疗记录。
诊断时的中位年龄为8岁，中位随访时间为39个月。所有患者的尿蛋白肌酐比（UPCR）均大于1.0 g/g，10例患者有低蛋白血症。肾脏病理结果分别为I级、II级和III级的患者有2例、14例和4例。所有患者均使用泼尼松龙治疗，13例患者使用环磷酰胺治疗。所有患者蛋白尿首次缓解的中位时间为6个月（范围2 - 47个月）。在末次随访时，13例患者（65%）蛋白尿缓解（缓解组），而7例患者（35%）蛋白尿复发（复发组），UPCR>0.2 g/g。有趣的是，缓解组蛋白尿首次缓解的中位时间短于复发组（6个月和19个月，p<0.001）。此外，诊断时的估计肾小球滤过率与末次随访时的UPCR呈负相关（r = -0.773，p = 0.001）。
表现为大量蛋白尿的小儿过敏性紫癜性肾炎患者治疗后预后良好。蛋白尿早期缓解的患者比晚期缓解的患者缓解期更长。
