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The significance of tubulointerstitial lesions in childhood Henoch–Schönlein nephritis

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Abstract

Background

Little information is currently available on the development of tubulointerstitial lesions in children with Henoch–Schönlein nephritis (HSN). To identify the impact of the development of tubulointerstitial changes in HSN, we retrospectively analyzed renal biopsies obtained from children with HSN.

Methods

Twenty-eight children with HSN from whom serial renal biopsies had been obtained before and after immunosuppressive therapy were enrolled in the study. The patients were divided into two groups according to the observed change in tubulointerstitial lesion development: group I (n = 15), with stable or improved tubulointerstitial lesions, and group II (n = 13), with worsened tubulointerstitial lesions. Group II patients had longer duration of proteinuria than group I patients (3.7 ± 3.7 years vs. 1.7 ± 1.7 years, p = 0.052).

Results

The change in serum albumin level was negatively correlated with the change in tubulointerstitial scores before and after treatment (γ = −0.444, p = 0.018). Group II patients showed a significant decrease in immunoglobulin G (IgG) and IgA deposits after treatment (p = 0.039 and 0.003, respectively), while group II patients did not (p = 0.458 and 0.506, respectively).

Conclusions

Although the International Study of Kidney Disease in Children classification of HSN does not include tubulointerstitial lesions, they can progress during treatment and could have significant clinical implications in association with the duration of proteinuria.

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Author notes

    Authors and Affiliations

    1. Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea

      Beom Jin Lim, Sung-eun Choi, Hyechang Rhim & Hyeon Joo Jeong

    2. Severance Institute for Vascular and Metabolic Research, Yonsei University College of Medicine, Seoul, South Korea

      Beom Jin Lim

    3. Department of Pediatrics, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, C.P.O. Box 8044, 120-752, South Korea

      Jae Il Shin, Jae Seung Lee, Pyung Kil Kim & Ji Hong Kim

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    1. Beom Jin Lim
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    Correspondence to Ji Hong Kim.

    Ethics declarations

    This study was approved by the institutional review board (IRB) and the research ethics committee of Yonsei University Gangnam Severance Hospital. The authors were exempted from obtaining informed consent by the IRB because this study was a retrospective one and personal identifiers were completely removed.

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    The authors declare that they have no conflict of interest regarding this work.

    Additional information

    Beom Jin Lim and Jae Il Shin contributed equally to this work.

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    Lim, B.J., Shin, J.I., Choi, Se. et al. The significance of tubulointerstitial lesions in childhood Henoch–Schönlein nephritis. Pediatr Nephrol 31, 2087–2093 (2016). https://doi.org/10.1007/s00467-016-3417-2

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    • DOI: https://doi.org/10.1007/s00467-016-3417-2

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