Fogazzi G B, Pasquali S, Moriggi M, Casanova S, Damilano I, Mihatsch M J, Zucchelli P, Ponticelli C
Department of Nephrology and Dialysis, Ospedale Maggiore Policlinico, Milano, Italy.
Clin Nephrol. 1989 Feb;31(2):60-6.
Sixteen adult patients with Schönlein-Henoch nephritis, selected by strict inclusion criteria, were studied retrospectively. At the time of discovery of the nephropathy, 11 patients had normal plasma creatinine and 5 other patients had renal insufficiency. All patients had renal biopsies, which were studied by both light and immunofluorescence microscopy. After a mean follow-up of 90.5 +/- 59.1 months (range 16-261), 3 patients were in chronic dialysis (18.7%), 8 other patients had renal function deterioration (50%), with creatinine clearance ranging from 31 to 60 ml/min. Four other patients had mild urinary abnormalities with normal plasma creatinine (25%) and only 1 patient was in complete clinical remission (6%). No clinical features at onset were predictive for the clinical outcome of the disease, while in the biopsies the percentage of crescents was higher in patients who developed renal insufficiency. High IgA serum levels were correlated (p = 0.0242) with a favorable course. It is concluded that Schönlein-Henoch nephritis of the adult carries a high long-term risk of renal dysfunction.
对16例根据严格纳入标准选取的成人过敏性紫癜性肾炎患者进行了回顾性研究。在发现肾病时，11例患者血浆肌酐正常，另外5例患者存在肾功能不全。所有患者均接受了肾活检，并通过光学显微镜和免疫荧光显微镜进行研究。经过平均90.5±59.1个月（范围16 - 261个月）的随访，3例患者进行慢性透析（18.7%），另外8例患者出现肾功能恶化（50%），肌酐清除率为31至60 ml/分钟。另外4例患者有轻度尿液异常但血浆肌酐正常（25%），只有1例患者完全临床缓解（6%）。发病时的临床特征对疾病的临床结局无预测性，而在肾活检中，出现肾功能不全的患者新月体百分比更高。高血清IgA水平与良好病程相关（p = 0.0242）。结论是成人过敏性紫癜性肾炎长期存在肾功能障碍的高风险。
