Clinical remission of Henoch–Scho¨nlein purpura nephritis after a monotherapeutic tonsillectomy

Clinical remission of Henoch–Scho¨nlein purpura nephritis after a monotherapeutic tonsillectomy

  • نوع فایل : کتاب
  • زبان : انگلیسی
  • مؤلف : Yoshitaka Iwazu Tetsu Akimoto Shigeaki Muto Eiji Kusano
  • چاپ و سال / کشور: 2011

Description

We herein describe an adult male patient who presented with tonsillitis, purpura, hematuria, and proteinuria. The serological analyses revealed elevated serum antistreptolysin, and the throat culture yielded Lancefield group A b-hemolytic streptococci. A renal biopsy revealed mild mesangial proliferation associated with granular mesangial depositions of IgA and C3, consistent with Henoch–Scho¨nlein purpura nephritis (HSPN). Initially, the patient was treated with dipyridamole, which was followed by limited improvements in the proteinuria and hematuria. Nine months later, the tonsillitis relapsed due to GAS infection and deteriorated urinary abnormalities were noticed, which finally disappeared after monotherapeutic tonsillectomy. Although the impact of tonsillectomy on the treatment of HSPN remains to be characterized, our observations suggest that tonsillectomy in the present patient played a pivotal role in facilitating the recovery of the renal injuries. Because the arbitrary application of a tonsillectomy appears to be accompanied by ethical concerns, the evaluation of the clinical benefits of this procedure should be addressed more directly in the future
Clin Exp Nephrol (2011) 15:132–135, Received: 7 June 2010 / Accepted: 16 August 2010 / Published online: 9 September 2010  Japanese Society of Nephrology 2010
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