Yoshikawa N, Ito H, Yoshiya K, Nakahara C, Yoshiara S, Hasegawa O, Matsuyama S, Matsuo T
Clin Nephrol. 1987 May;27(5):233-7.
The clinical presentation, initial laboratory and renal biopsy findings, and subsequent clinical course were studied and compared in 128 children with Henoch-Schoenlein (HS) nephritis and in 206 children with IgA nephropathy. The clinical and pathological findings of the two conditions were similar. After a mean follow-up period of 5 years, 72 patients (56%) with HS nephritis and 67 (32%) with IgA nephropathy showed no demonstrable abnormality, 29 (23%) with HS nephritis and 103 (50%) with IgA nephropathy had minor urinary abnormalities, 7 (5%) with HS nephritis and 26 (13%) with IgA nephropathy had heavy proteinuria and/or hypertension, and 20 (16%) with HS nephritis and 10 (5%) with IgA nephropathy had developed chronic renal failure. A worse outcome was significantly associated with the more severe clinical presentations and more severe glomerular changes by light microscopy in HS nephritis, whereas there was no relationship between the severity of clinical presentation and glomerular changes and prognosis in IgA nephropathy. These findings suggest that HS nephritis is an acute disease and prognosis is associated with the severity of glomerular changes at onset, while IgA nephropathy is a chronic, slowly progressive glomerular disease.
对128例紫癜性（HS）肾炎患儿和206例IgA肾病患儿的临床表现、初始实验室及肾活检结果以及随后的临床病程进行了研究和比较。这两种疾病的临床和病理表现相似。平均随访5年后，72例（56%）紫癜性肾炎患儿和67例（32%）IgA肾病患儿未显示出明显异常，29例（23%）紫癜性肾炎患儿和103例（50%）IgA肾病患儿有轻微的尿液异常，7例（5%）紫癜性肾炎患儿和26例（13%）IgA肾病患儿有大量蛋白尿和/或高血压，20例（16%）紫癜性肾炎患儿和10例（5%）IgA肾病患儿发展为慢性肾衰竭。紫癜性肾炎中，更差的预后与更严重的临床表现以及光镜下更严重的肾小球改变显著相关，而在IgA肾病中，临床表现的严重程度与肾小球改变及预后之间没有关系。这些发现表明，紫癜性肾炎是一种急性疾病，预后与发病时肾小球改变的严重程度相关，而IgA肾病是一种慢性、进展缓慢的肾小球疾病。
