Comparion Of Adult IgA Nephropathy And Henoch Schonlein Purpura Nephritis In Patients With Nephrotic Syndrome

Objective:Through retrospective analysis the differences and relations of adult IgA nephropathy and Henoch Schonlein purpura nephritis patients with nephrotic syndrom in general pathology,clinical manifestations,laboratory examination data and pathological data,in order to assist the clinicians to judge more accurately during the clinical work,better to grasp the treatments' opportunity,individualized treatment programs for patients and make a greater degree of improve the prognosis.Materials and Methods:A collection of cases with IgA nephropathy and Henoch Schonlein purpura nephritis by renal biopsy in nephrology department of the First Hospital of Jilin University from October 2010 to April 2017.The selected patients were over 18 years old with nephrotic syndrome,ruling out the secondary nephropathy caused by lupus nephritis,diabetic nephropathy,hypertensive nephropathy,renal amyloidosis and multiple myeloma.Here were 86 cases of IgA nephropathy and 17 cases of Henoch Schonlein purpura nephritis.The database was established with SPSS 18.0 statistical software,which made the analysis of the characteristics,clinical features,laboratory data and renal pathological features and made a collection of the relationship and differences between them.Result:Between October 2010 and April 2017,a total of 2231 cases of renal biopsy patients were performed in our hospital.There were 438 cases of primary IgA nephropathy aged 18 years or older,of which 86 cases were manifested as nephrotic syndrome,accounting for 19.63%;64 cases of adult purpura nephritis,of which 17 cases were adult nephritis with nephrotic syndrome,accounting for 26.56%.In this study,the proportion of males and females in the IgA nephropathy group was 1.32:1;the ratio of males and females in the purpura nephritis group was 1.43:1,and there was no statistical difference between the two groups.Among the adult patients with IgA nephropathy and purpura nephritis whose main manifestations were nephrotic syndrome,the youngest adults aged 18-44 were the most common.The duration of onset of renal biopsy in the IgA nephropathy group was longer than that of the purpura nephritis group(P<0.05).The proportion of patients with a clear allergic history in the purpura nephritis group was higher than that in the IgA nephropathy group(P<0.05).Patients with purpura nephritis appeared The proportion of skin rash,joint pain,and gastrointestinal symptoms were higher in the IgA nephropathy group(P<0.05),and the cholesterol level in the IgA nephropathy group was higher than that in the purpura nephritis group(P < 0.05).The renal pathology of the kidneys showed immune complexes in both groups.There were differences in sedimentation sites(P < 0.05).The renal pathology of purpura nephritis group showed that the formation of crescents and endothelium was more than IgA nephropathy group(P<0.05),both in spherical sclerosis,focal segmental sclerosis,focal segment There was no statistically significant difference in segmental hyperplasia and diffuse systemic hyperplasia.There was no difference in the type of renal pathological immune complex deposition in the IgA nephropathy group and the purpura nephritis group.Compared with the IgA nephropathy group,the renal pathological activity index was observed in the purpura nephritis group.Higher(P<0.05),with glomerular mobility index higher than IgA nephropathy group(P<0.05).Conclusion:1.Compared with Henoch Schonlein purpura nephritis,IgA nephropathy patients in adults with nephrotic syndrome have slightly longer renal biopsy time and slightly higher cholesterol level.2.Compared with the renal pathology of IgA nephropathy and Henoch Schonlein purpura nephritis in adults with nephrotic syndrome,there were differences in the sites of immune complex deposition,and the activity score of renal pathological changes was slightly lower.