Successful therapy with tonsillectomy for severe ISKDC grade VI Henoch–Scho¨nlein purpura nephritis and persistent nephrotic syndrome
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Shinichiro Ohara Yukihiko Kawasaki Hiromi Matsuura Tomoko Oikawa Kazuhide Suyama Mitsuaki Hosoya
- چاپ و سال / کشور: 2011
Description
Henoch–Scho¨nlein purpura (HSP) is a systemic disorder characterized by leukocytoclastic vasculitis involving the capillaries and the deposition of IgA immune complexes. Renal involvement is the principal cause of morbidity and mortality in children with HSP. We report here a 13-year-old girl with Henoch–Scho¨nlein purpura nephritis (HSPN) of International Study of Kidney Disease in Children (ISKDC) grade VI and persistent nephrotic syndrome despite receiving conventional therapy, such as prednisolone, methylprednisolone and urokinase pulse therapy and plasmapheresis (PP). The patient was treated with tonsillectomy, which subsequently decreased proteinuria, induced the disappearance of microscopic hematuria, and improved renal pathological findings. A regimen of methylprednisolone and urokinase pulse therapy plus PP with tonsillectomy may be an effective and useful therapy for some children with severe HSPN children of ISKDC grade VI and persistent nephrotic syndrome.
Received: 25 January 2011 / Accepted: 11 May 2011 Japanese Society of Nephrology 2011 Clin Exp Nephrol
