A Clinical and Histological Study on Anaphylactoid(Henoch-Schnlein purpura)Nephritis in children

ABSTRACT

Anaphylactoid nephritis is a disease complicated by anaphylactoid purpura manifested by a non-thrombocytopenic purpura, abdominal pain. And joint pain The manifestation of nephritis may vary from microscopic hematuria to acute rapidly progressive nephritic and nephrotic syndrome. This paper reports on anaphylactoid nephritis in children. These cases were collected fromthe Department of Pediatrics, Yonsei university Medical College from January 1,1974 to may 31, 1979. The results are as follows; 1. Among 75 cases of anaphylactoid purpura, 25 cases developed nephritis(33%), 16 cases were male and 9female. The age distribution was from 3years 5months to 15years. The peak incidence occured between 5 and 7years ofage with 11 cases. 2. The evidence of renal invovement in 18 cases among 25 were detected within 4 weeks after onset of skin manifestation. 3. The clinical manifestations were skin rashes, abdominal pain, joint pain, pitting edema, gross hematuria, and melena in orders. 4. The clinical classification of renal involvement were transient hematuria 4 cases, acute nephritis, 7 cases recurrent hematuria 1 case, nephrotic syndrome 5 cases, and undetermined 8 cases. 5. In additionto the usual signs of renal involvement, serum levels of IgA were checked. The elevation of IgA was 4 cases among the tested 6 cases. 6. According to the pathologic findings and immunofluorescent technique, 8 cases out of 9 cases by kidney biopsy were focal proliferative glomerulonephritis and 1 case diffuse proliferative flomerulonephritis. The deposit of glomeruli by immunofluorescent technique was IgA, IgG, IgM, and fibrin 7. All the cases were treated with prednisone and only 4 cases were combined with immunosuppressant, azathioprine without benfit.