儿童弥漫性毛细血管内增生性紫癜性肾炎的临床特征及预后
Clinical features and outcomes of diffuse endocapillary proliferation Henoch-Schönlein purpura nephritis in children.
作者信息
Fu Haidong, Mao Jianhua, Xu Yanping, Gu Weizhong, Zhu Xiujuan, Liu Aimin
机构信息
The Children's Hospital of Zhejiang University School of Medicine, Department of Nephrology, Hangzhou 310003, China.
出版信息
Clinics (Sao Paulo). 2016 Sep;71(9):550-4. doi: 10.6061/clinics/2016(09)11.
OBJECTIVE
To investigate the outcomes of childhood diffuse endocapillary proliferation Henoch-Schönlein purpura nephritis (DEP-HSPN) in response to early diagnosis and prompt treatment.
METHODS
Eleven cases of DEP-HSPN in children were investigated in comparison to HSPN without diffuse endocapillary proliferation (non-DEP-HSPN).
RESULTS
DEP-HSPN had a higher prevalence of nephrotic syndrome but a lower prevalence of hematuria compared to non-DEP-HSPN. IgA, IgG and IgM antibody deposition was found in DEP-HSPN by histopathological examination. Proteinuria cleared in all 11 cases through treatment with steroids and/or immunosuppressive drugs. However, half of the DEP-HSPN patients continuously had hematuria after treatment.
CONCLUSION
The early diagnosis and prompt initiation of immunosuppressive treatment based on renal biopsy are important for achieving favorable outcomes.
目的
探讨儿童弥漫性毛细血管内增生性紫癜性肾炎（DEP-HSPN）早期诊断并及时治疗的效果。
方法
对11例儿童DEP-HSPN进行研究，并与无弥漫性毛细血管内增生的紫癜性肾炎（非DEP-HSPN）进行比较。
结果
与非DEP-HSPN相比，DEP-HSPN的肾病综合征患病率较高，但血尿患病率较低。通过组织病理学检查在DEP-HSPN中发现了IgA、IgG和IgM抗体沉积。所有11例患者经类固醇和/或免疫抑制药物治疗后蛋白尿均消失。然而，一半的DEP-HSPN患者治疗后仍持续存在血尿。
结论
基于肾活检进行早期诊断并及时开始免疫抑制治疗对于取得良好疗效很重要。
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