Skip to main content
SpringerLink
Log in

Henoch-Schönlein Purpura and IgA Nephropathy: To Separate or Unify?

  • Chapter
IgA Nephropathy

Part of the book series: Topics in Renal Medicine ((TIRM,volume 2))

Abstract

Henoch-Schönlein purpura (HSP) is a readily recognizable clinical syndrome familiar to most physicians and characterized by the appearance of a vasculitic rash especially on the legs and buttocks, flitting arthropathy, gastrointestinal problems, and glomerulonephritis. The introduction of immunofluorescence studies of renal biopsies brought confirmation of the immunologic nature of the pathologic lesions and the remarkable similarity between the renal lesion of HSP and IgA nephropathy. This chapter explores the differences and similarities between the two conditions and points strongly to a concept of unity. To this time, however, this concept is not proved; proof probably awaits a specific diagnostic test similar to the L.E. cell or antinuclear antibody test in systemic lupus erythematosus.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Nakamoto Y, Asano Y, Dahi K, Fujioka M, Ida H, Keda H, Kibe Y, Hattori N, Takeuchi S: Primary IgA glomerulonephritis and Schönlein-Henoch purpura nephritis: clinicopathological and immunohistological characteristics. Q J Med 47:495–516, 1978.

    PubMed  CAS  Google Scholar 

  2. Weiss JH, Bhathena DB, Curtis JJ: A possible relationship between Henoch-Schönlein syndrome and IgA nephropathy (Berger’s disease). Lancet 1:347, 1975.

    Google Scholar 

  3. Meadow, SR, Scott DG: Berger’s disease: Henoch-Schönlein syndrome without the rash. J Pediatr 106:27–32, 1985.

    Article  PubMed  CAS  Google Scholar 

  4. Counahan R, Winterborn MH, White RHR, Heaton JM, Meadow SR, Bluett NH, Swetschin H, Cameron JS, Chantler C: Prognosis of Henoch-Schönlein nephritis in children. Br Med J 2:11–14, 1977.

    Article  PubMed  CAS  Google Scholar 

  5. Bywaters EGL, Isdale I, Kempton JJ: Schönlein-Henoch purpura evidence for a group A, beta-haemolytic streptococcal infection. Q J Med 26:261–274, 1957.

    Google Scholar 

  6. Ackroyd JF: Allergic purpura, including purpura due to food, drugs and infections. Am J Med 14:605–610, 1953.

    Article  PubMed  CAS  Google Scholar 

  7. McCombs RP, Patterson JF, MacMahon HE: Syndromes associated with “allergic” vasculitis. N Engl J Med 255:251–261, 1956.

    Article  PubMed  CAS  Google Scholar 

  8. Cairns SA, Mallick NP, Lawler W, Williams G: Squamous cell carcinoma of the bronchus presenting with Henoch-Schönlein purpura. Br Med J 3:474–475, 1978.

    Article  Google Scholar 

  9. Levy M, Moussa RA, Habib R, Gagnadoux MF, Broyer M: Anaphylactoid purpura nephritis and transplantation [abstr]. Kidney Int 22:326, 1982.

    Google Scholar 

  10. Meadow SR, Glasgow EF, White RHR, Moncrieff MW, Cameron JS, Ogg CS: Schönlein-Henoch nephritis. Q J Med 41:241–258, 1972.

    PubMed  CAS  Google Scholar 

  11. Emancipator SN, Gallo GR, Lamm ME: IgA nephropathy: perspectives on pathogenesis and classification. Clin Nephrol 24:161–179, 1985.

    PubMed  CAS  Google Scholar 

  12. Levy M, Gonzalez-Burchard G, Broyer M, Dommergues J-P, Foulard M, Sorez J-P Habib R: Berger’s disease in children: natural history and outcome. Medicine 64:157–180, 1985.

    PubMed  CAS  Google Scholar 

  13. Mihatsch MJ, Imbasciati E, Fogazzi G, Giani M, Ghio L, Gaboardi F: Ultrastructural lesions of Henoch-Schonlein syndrome and of IgA nephropathy: similarities and differences. Contrib Nephrol 40:255–263, 1984.

    PubMed  CAS  Google Scholar 

  14. Thompson AJ, Chan Y-L, Woodroffe AJ, Clarkson AR, Seymour AE: Vascular IgA deposits in clinically normal skin of patients with renal disease. Pathology 12:407–413, 1980.

    Article  PubMed  CAS  Google Scholar 

  15. Baart de la Faille Kuyper EH, Kater L, Kuitjen RH, Kooiker CJ, Wagenaar SS, Van der Zowen P, Doorhaut Mees EJ: Occurrence of vascular IgA deposits in clinically normal skin of patients with renal disease. Kidney Int 9:424–429, 1976.

    Article  Google Scholar 

  16. Waldherr R, Rambauser M, Rauterberg W, Andrassy K, Ritz E: Immunohistochemical features of mesangial IgA glomerulonephritis. Contrib Nephrol 40:99–106, 1984.

    PubMed  CAS  Google Scholar 

  17. D’Amico G, Ferrario F, Colasanti G, Ragni A, Bestetti-Bosisio, M: IgA mesangial nephropathy (Berger’s disease) with rapid decline in renal function. Clin Nephrol 16:251–257, 1981.

    PubMed  Google Scholar 

  18. Hasbargen JA, Copley JB: Utility of skin biopsy in the diagnosis of IgA nephropathy. Am J Kidney Dis 6:100–102, 1985.

    PubMed  CAS  Google Scholar 

  19. Tomino Y, Endoh M, Miura M, Nomoto Y, Sakai H: Immunopathological similarities between IgA nephropathy and Henoch-Schonlein purpura nephritis. Acta Pathol Jpn 33:113–122, 1983.

    PubMed  CAS  Google Scholar 

  20. Tomino Y, Endoh M, Suga T, Miura M, Kaneschige H, Nomoto Y, Sakai H: Prevalence of IgA1 deposits in Henoch-Schonlein purpura (HSP) nephritis. Toka J Exp Clin Med 7:527–532, 1982.

    CAS  Google Scholar 

  21. Andre C, Berthous FC, Andre F, Gillon G, Genin C, Sabatier JC: Prevalence of IgA2 deposits in IgA nephropathies: a clue to their pathogenesis. N Engl J Med 303:1343–1346, 1980.

    Article  PubMed  CAS  Google Scholar 

  22. Egido J, Sancho J, Mampaso F, Lopez-Trascasa M, Sanchez Crespo M, Blasco R, Hernando L: A possible common pathogenesis of the mesangial IgA glomerulonephritis in patients with Berger’s disease, and Schönlein-Henoch syndrome. Proc Eur Dial Transplant Assoc 17:660–666, 1980.

    PubMed  CAS  Google Scholar 

  23. Garcia-Fuentes M, Chantler C, Williams DG: Cryoglobulinemia in Henoch-Schönlein purpura. Br Med J 2:163–165, 1977.

    Article  PubMed  CAS  Google Scholar 

  24. Coppo R, Basolo B, Piccoli G, Mazzucco G, Bulzomi MR, Roccatello D, Di Marchi M, Carbonara AO, Barbiano Di Belgiojoso G: IgA1 and IgA2 immune complexes in primary IgA nephropathy and Henoch-Schönlein nephritis. Clin Exp Immunol 57:583–590, 1984.

    PubMed  CAS  Google Scholar 

  25. Levinsky RJ, Barratt TM: IgA immune complexes in Henoch-Schönlein purpura. Lancet 2:1100–1102, 1979.

    Article  PubMed  CAS  Google Scholar 

  26. Woodroffe AJ, Gormly AA, McKenzie PE, Wootton AM, Thompson AJ, Seymour AE, Clarkson AR: Immunologic studies in IgA nephropathy. Kidney Int 18:366–374, 1980.

    Article  PubMed  CAS  Google Scholar 

  27. Bannister KM, Drew PA, Clarkson AR, Woodroffe AJ: Immunoregulation in glomerulonephritis, Henoch-Schönlein purpura and lupus nephritis. Clin Exp Immunol 53:384–390, 1983.

    PubMed  CAS  Google Scholar 

  28. Beale MG, Nash GS, Bertovich MJ, McDermott P: Similar disturbances of B-cell activity and regulatory T-cell function in Henoch-Schönlein purpura and systemic lupus erythematosus. J Immunol 128:486–491, 1982.

    PubMed  CAS  Google Scholar 

  29. Casanueva B, Rodriguez-Valverde V, Merino J, Arias M, Garcia-Fuentes M: Increased IgA producing cells in the blood of patients with active Henoch-Schönlein purpura. Arthritis Rheum 26:854–860, 1983.

    Article  PubMed  CAS  Google Scholar 

  30. Hale GM, Mcintosh SL, Hiki Y, Clarkson AR, Woodroffe AJ: Evidence for IgA-specific B-cell hyperactivity in patients with IgA nephropathy. Kidney Int 29:718–724, 1986.

    Article  PubMed  CAS  Google Scholar 

  31. Bannister KM, Hay J, Clarkson AR, Woodroffe AJ: Fc-specific reticulo-endothelial clearance in systemic lupus erythematosus and glomerulonephritis. Am J Kidney Dis 3:287–292, 1984.

    PubMed  CAS  Google Scholar 

  32. Lawrence S, Pussell BA, Charlesworth JA: Mesangial IgA nephropathy: detection of defective reticulo-phagocytic function in vivo. Clin Nephrol 16:280–283, 1983.

    Google Scholar 

  33. Hene RJ, Kater L: Plasmapheresis in nephritis associated with Henoch-Schönlein purpura and in primary IgA-nephropathy. Plasma Ther Transfus Technol 4:165–173, 1983.

    Google Scholar 

  34. Kauffmann RH, Houwert DA: Plasmapheresis in rapidly progressive Henoch-Schönlein glomerulonephritis and the effect on circulating immune complexes. Clin Nephrol 16:155–160, 1981.

    Google Scholar 

  35. McKenzie PE, Taylor AE, Woodroffe AJ, Seymour AE, Chan Y-L, Clarkson AR: Plasmapheresis in glomerulonephritis. Clin Nephrol 12:97–108, 1979.

    PubMed  CAS  Google Scholar 

  36. Coppo R, Basolo B, Martina G, Rollino C, Di Marchi M, Giacchino F, Mazzucco G, Messina M, Piccoli G: Circulating immune complexes containing IgA, IgG and IgM in patients with primary IgA nephropathy and with Henoch-Schönlein nephritis: correlation with clinical and histologic signs of activity. Clin Nephrol 18:230–239, 1982.

    PubMed  CAS  Google Scholar 

  37. Danielsen H, Eriksen EF, Johansen A, Solling J: Serum immunoglobulin sedimentation patterns and circulating immune complexes in IgA glomerulonephritis and Schönlein-Henoch nephritis. Acta Med Scand 215:435–441, 1984.

    Article  PubMed  CAS  Google Scholar 

  38. Kauffmann, RH, Herrmann WA, Meyer CJLM, Daha MR, Van Es LS: Circulating IgA immune complexes in Henoch-Schönlein purpura: a longitudinal study of their relationship to disease activity Am J Med 68:859–866, 1980.

    Article  Google Scholar 

Download references

Authors
  1. Anthony R. Clarkson
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Anthony R. Clarkson

Rights and permissions

Reprints and permissions

Copyright information

© 1987 Martinus Nijhoff Publishing, Boston

About this chapter

Cite this chapter

Clarkson, A.R. (1987). Henoch-Schönlein Purpura and IgA Nephropathy: To Separate or Unify?. In: Clarkson, A.R. (eds) IgA Nephropathy. Topics in Renal Medicine, vol 2. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-2039-5_4

Download citation

  • DOI: https://doi.org/10.1007/978-1-4613-2039-5_4

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4612-9213-5

  • Online ISBN: 978-1-4613-2039-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation