Frequency of Renal Involvement and Its Characteristics in Patients With Henoch-Schönlein Purpura

This study investigated the frequency of renal involvement and its characteristics in patients with Henoch-Schönlein purpura who were referred to Hazrat Masoumeh Hospital in Qom City, Iran.

In this retrospective study, the files of 49 patients with Henoch-Schönlein purpura were reviewed. All clinical and paraclinical findings of the patients were reviewed, and the prevalence of renal complications in these patients was evaluated.

In this study, 28 boys (57.1%) and 21 girls (42.9%) with an mean age of 53.7±35.3 months were examined. Three patients (6.1%) had underlying diseases, three patients (6.1%) had edema, 18 patients (36.7%) had arthritis, nine patients (18.4%) had petechiae, ten patients (20.4%) had abdominal pain, seven patients (14.3%) had leukocyturia, nine patients (18.4%) had microhematuria and hematuria, and three patients (6.1%) had proteinuria. The average creatinine and average blood urea levels were 0.6±0.1 and 25.4±11.1, respectively. Creatinine levels were elevated in 5 cases (10.2%) at the time of diagnosis and in 3 cases (6.1%) during the second week. Eight patients (16.3%) had kidney failure, and in three of these patients, there was an increase in proteinuria at the time of diagnosis. Additionally, three patients showed recovery, with improvement noted in two of these patients two weeks later and in one patient after the next six months. We observed disease recurrence in one patient (2%), nephrotic syndrome in one patient (2%), and proteinuria in two patients. In 33 cases (67.3%), no treatment was needed; ten cases were treated with non-steroidal anti-inflammatory drugs, three cases (6.1%) with Lasix, and the same number of cases were treated with corticosteroids. Also, among the patients who received treatment, one patient (3%) did not respond to the treatment.

Considering the kidney complications associated with this disease and the need for long-term follow-up for timely diagnosis, if any child is diagnosed with similar conditions, the follow-up of patients can help control and prevent these issues to a large extent.