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Comparison between adults and children with Henoch–Schönlein purpura nephritis

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Abstract

Background

Henoch–Schönlein purpura (HSP) mainly affects children, but age is also thought to be an important prognostic factor. Kidney involvement is a major cause of mortality in HSP patients. The purpose of this study was to analyze the clinicopathological correlations between adults and children.

Methods

A total of 208 children and 75 adult patients with HSP nephritis (HSPN) were evaluated. All patients underwent a renal biopsy.

Results

Extra-renal symptoms (arthritis and abdominal pain) were more common in the pediatric patient group than in the adult group (P < 0.05), but renal symptoms (edema and hypertension) were relatively rare (P < 0.05). A significant positive correlation was noted between pathological type and clinical type (P < 0.01). Pathological activity was positively related to renal failure, abdominal pain, microscopic hematuria, hypertension, and proteinuria (P < 0.05). Pathological chronicity was positively associated with age, duration of follow-up since the onset of palpable purpura, renal failure, lower extremity edema, hypertension, and proteinuria (P < 0.05).

Conclusions

Various clinicopathological differences exist between children and adults with HSPN. Massive proteinuria, renal failure, and abdominal pain usually correlated with severe pathology. Renal biopsy should be performed in both pediatric and adult HSPN patients with repeated hematuria and/or consistent minimal proteinuria.

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Acknowledgments

We would like to thank Dr. JianJiang Zhang (Department of Pediatrics, First Affiliated Hospital of Zhengzhou University) for providing the pediatric patient cases, Dr. Songxia Quan (Department of Renal Pathology, First Affiliated Hospital of Zhengzhou University) for advice regarding renal pathology, and Dr. Jin Zhang for providing help with the statistical analysis.

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Authors and Affiliations

  1. Department of Nephrology, First Affiliated Hospital of Zhengzhou University, No.1, JianShe East Road, Zhengzhou, Henan Province, The People’s Republic of China

    Shan Lu, Dong Liu, Jing Xiao, Wenming Yuan, Xiaoyang Wang, Xiaoxue Zhang, Zhangsuo Liu & Zhanzheng Zhao

  2. Department of Thoracic Surgery, Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, The People’s Republic of China

    Jin Zhang

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  1. Shan Lu
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  2. Dong Liu
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Correspondence to Zhanzheng Zhao.

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Lu, S., Liu, D., Xiao, J. et al. Comparison between adults and children with Henoch–Schönlein purpura nephritis. Pediatr Nephrol 30, 791–796 (2015). https://doi.org/10.1007/s00467-014-3016-z

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  • DOI: https://doi.org/10.1007/s00467-014-3016-z

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