Basu Keya, Addya Soma, Mukherjee Sriranjan, Sengupta Moumita, Pandey Rajendra, Chatterjee Gobinda, Bandopadhyay Manimoy
Department of Pathology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India.
Department of Nephrology, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, West Bengal, India.
Saudi J Kidney Dis Transpl. 2022 Sep 1;33(5):693-701. doi: 10.4103/1319-2442.389429. Epub 2023 Nov 7.
Henoch-Schönlein purpura (HSP) is a small vessel vasculitis with multiorgan involvement. Renal involvement is the key factor predicting morbidity. We have aimed to analyze the clinicopathological spectrum of HSP vasculitis and HSP nephritis to assess the risk factors associated with kidney involvement. This retrospective study was performed in the department of pathology with collaboration of department of dermatology and department of nephrology of a tertiary care center. All clinical details along with biopsy findings were retrieved. Starting materials of the study were cases of leukocytoclastic vasculitis with only perivascular IgA deposit of more than ++ in the absence of other immunoglobulin and trace complements. To investigate the possible factors that are influential on the development of biopsy-proven HSP nephritis, we divided the whole study population in two groups -group 1: with and group 2: without biopsy-proven nephritis. One-way analysis of variance was carried out during comparative analysis between two groups using IBM SPSS statistics software, version 19 and MedCalc software, version 12.3.0.0. HSP vasculitis comprised 11.6% (n = 19) of total cutaneous vasculitis in 2 years (164 cases) with a mean age of 13.52 ± 8.10 (range: 4-33 years). Three cases developed de novo kidney disease (15.79%). A correlation analysis revealed that predictors were seasonal variation (P = 0.018), severe gastrointestinal involvement (P = 0.03), and subcutaneous edema (P = 0.005). Various clinical and laboratory parameters were associated with renal consequences. Occult nephritis was the most common presentation with crescent as a constant histopathological feature.
过敏性紫癜（HSP）是一种累及多器官的小血管炎。肾脏受累是预测发病率的关键因素。我们旨在分析HSP血管炎和HSP肾炎的临床病理谱，以评估与肾脏受累相关的危险因素。这项回顾性研究是在一家三级医疗中心的病理科与皮肤科和肾内科合作下进行的。检索了所有临床细节以及活检结果。研究的起始材料是白细胞破碎性血管炎病例，在无其他免疫球蛋白和微量补体的情况下，仅血管周围IgA沉积超过++。为了研究对经活检证实的HSP肾炎发展有影响的可能因素，我们将整个研究人群分为两组——第1组：有经活检证实的肾炎和第2组：无经活检证实的肾炎。在两组之间进行比较分析时，使用IBM SPSS统计软件19版和MedCalc软件12.3.0.0进行单因素方差分析。HSP血管炎占2年（164例）总皮肤血管炎的11.6%（n = 19），平均年龄为13.52±8.10（范围：4 - 33岁）。3例出现新发肾病（15.79%）。相关性分析显示，预测因素为季节变化（P = 0.018）、严重胃肠道受累（P = 0.03）和皮下水肿（P = 0.005）。各种临床和实验室参数与肾脏后果相关。隐匿性肾炎是最常见的表现，新月体是持续的组织病理学特征。
