RENAL INVOLVEMENT IN SCHÖNLEIN‐HENOCH PURPURA

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Abstract
Koskimies, O., Rapola, J., Savilahti, E. and Vilska, J. (The Children's Hospital, University of Helsinki, Helsinki, Finland). Renal involvement in Schonlein‐Henoch purpura. Acta Paediatr Scand, 63: 357, 1974.–During the period 1964–71 Schönlein‐Henoch syndrome was found in 91 children. Fifty‐four showed no signs of renal disease and recovered rapidly. Eighteen patients with haematuria or proteinuria lasting less than 4 weeks also made full recovery. Nineteen patients had persisting urinary abnormalities and were followed‐up clinically and with biopsies. Immunotluorescent and electron microscopic studies were performed in 6 patients.Histopathological changes correlated well with the severity of the disease. Generalized proliferative glomerulonephritis, sometimes with glomerular fibro‐epithelial crescents, signified severe disease with protracted course. Most of these cases had heavy proteinuria and often nephrotic syndrome. The outcome after a follow‐up of 2 years was good, however. Twelve patients recovered completely and 6 were clinically symtomless but showed minor urinary abnormalities. Only one died and she had showed fulminant clinical and histopathological glomerulonephritis from the beginning of the disease.Immunotluorescent studies showed positive reactions in the mesahgium and glomerular capillaries in 4 patients. In the electron microscopy dense deposits were found at the corresponding sites. In two late biopsies immunotluorescence was negative despite definitive histological changes suggesting disappearance of the immunopathogenetic effectors of the nephritis.

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