The Clinical And Pathological Characteristic Of 98 Children With Henoch-sch?nlein Purpura Nephritis

ObjectiveThis study investigated the clinical manifestations and renal pathological characteristics of children with Henoch-Sch?nlein purpura nephritis(HSPN) to explore the relationship between clinical manifestations and renal pathology in HSPN.MethodsThe analysis was performed retrospectively in 98 children with HSPN admitted to The Children’s Hospital Affiliated to Soochow University from Jan.2011 to Dec.2014 about clinical manifestations, laboratory examination and renal histopathology to explore the relationship among glomerular pathological classification,clinical manifestations and interstitial pathological classification, and the difference of urinary protein,the erythrocytes in urine and the leucocyturia between different group classified by glomerular pathological classification.ResultsThe most common clinical type was hematuria with proteinuria(47cases,48%) followed by simple hematuria or proteinuria(30cases,30.6%).The majority of pathological grades were GradeⅡ(52cases,53.1%)including GradeⅡa(20cases,20.4%),and GradeⅡb(32cases,32.7%)and interstitial pathological grades were Grade+(77cases,78.6%). Twenty-one out of thirty patients(70%)with simple hematuria or proteinuria had an ISKDC classification of grade Ⅱ.53.2% cases(25/47)with hematura and proteinuria had a classification of Grade Ⅱ-Ⅲ.3 cases with acute nephritis had a classification of Grade Ⅱb occupied 75%.While the most cases with nephrotic syndrome came out the GradeⅢ-Ⅳ.One case with rapidly progressive glomerulonephritis had a classification of Grade Ⅳb while the chronic glomerular came out Grade Ⅲb.The main immune complex deposition were the isolated Ig A deposition(51cases,52.0%)while 8 cases(8.2%)with Ig A negative. The majority were accompanied with complement C3(64cases,65.3%)and fibrinogen(75cases,76.5%),while complement C1 q was detected in just one cases. Severe extent of renal injury has relationship with the increment of microalbumin, transferrin,immunoglobulin and 24-hour urinary protein.Glomerular pathological classification is almost concerned with the amount of leukocytes in urine,while has nothing to do with the erythrocytes in urine.ConclusionThe severe extent of renal injury is almost consistant with the increment of urinary protein and interstitial pathological classification.There were no significantly differences of pathological category among the types of the deposits.Glomerular pathological classification is possibly correlated with the amount of leukocytes in urine,while there is on obvious correlation between glomerular pathological classification and the amount of erythrocytes in urine.