| Childhood Henoch-Schonlein nephritis: a multivariate analysis of clinical features and renal morphology at disease onset. | |
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MedLine Citation:
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PMID: 19377254 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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INTRODUCTION: Risk factors of renal involvement in Henoch-Schonlein nephritis (HSN) have been extensively studied, but their relations with the severity of glomerular lesions at the disease onset are much less known. MATERIALS AND METHODS: Data were collected retrospectively on 45 patients (age range, 2 to 15 years) with HSN to identify the initial clinical and laboratory features that most accurately correlate with histological findings. Nephritic syndrome was defined as hypertension, proteinuria, hematuria, and a creatinine clearance of 60 mL/min/1.73 m2 or less. Kidney biopsy findings were graded according to the International Study of Kidney Disease in Children classification for HSN. RESULTS: Purpura was present in all the 45 children, arthritis in 73.3%, abdominal symptoms with or without bleeding in 68.6%, and a high serum IgA level in 24.4%. Hematuria was present in 88.6% of the patients, hematuria and proteinuria (not in nephrotic range) in 66.7%, nephrotic syndrome in 17.8%, acute nephritic syndrome in 8.9%, and nephritic-nephrotic syndrome in 13.3%. Grades II (33.3%) and III (22.2%) lesions were the most common pathologic findings on kidney biopsy followed by grades IV (17.8%), V (15.6%), and I (11.1%) lesions. Univariate analysis demonstrated that nephrotic syndrome, acute nephritic syndrome and a creatinine clearance less than 30 mL/min/1.73 m2 were all associated with a significantly increased risk of developing grades IV and/or V lesions. multivariate analysis showed nephritic-nephrotic syndrome as significant independent predictors of severity of glomerular disease at onset. CONCLUSIONS: The severity of renal symptoms at onset determines the intensity of glomerular lesions. |
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Authors:
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Farahnak Assadi |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Iranian journal of kidney diseases Volume: 3 ISSN: 1735-8582 ISO Abbreviation: Iran J Kidney Dis Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2009-04-20 Completed Date: 2009-05-20 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101316967 Medline TA: Iran J Kidney Dis Country: Iran |
Other Details:
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Languages: eng Pagination: 17-21 Citation Subset: IM |
Affiliation:
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Department of Pediatrics, Section of Nephrology, Rush University Medical Center, Chicago 60612, USA. fassadi@rush.edu |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Child Child, Preschool Cohort Studies Female Glomerular Filtration Rate Glomerulonephritis / etiology*, pathology* Humans Male Purpura, Schoenlein-Henoch / complications*, pathology*, physiopathology Retrospective Studies |
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