ESPN 51th Annual Meeting

ESPN 2018


 
HENOCH-SCHĂ–NLEIN PURPURA NEPHRITIS IN CHILDREN: CLINICOPATHOLOGIC CORRELATIONS
TUR NATALLIA 1 SAVOSH VICTORIA 2 LETKOUSKAYA TATJANA 2 CHERSTVOY EUGENIJ 2 SUKALO ALIAKSANDR 2

1- REPUBLIC CENTER OF PEDIATRIC NEPHROLOGY AND RENAL REPLACEMENT THERAPY, MINSK, BELARUS
2- BELARUS STATE MEDICAL UNIVERSITY, MINSK, BELARUS
 
Introduction:

 

Henoch-Schönlein purpura (HSP) prognosis is mostly dependent upon the severity of renal involvement.

The purpose of this study was to determine the correlations between clinical and pathologic findings in Henoch-Schonlein nephritis (HSPN)

Material and methods:

 All children with HSPN diagnosed between 2008 and 2017 in Belarus Republic Center of Pediatric Nephrology were included. Clinical and histological findings of 24 children (9,0 +/ -4,3 years) with HSPN were evaluated retrospectively. Immunohistochemical staining were performed in all cases. All patients had single or dominant mesangial IgA expression. Hematuria and non-nephrotic proteinuria were the most common laboratory findings of HSN. Four children had renal function impairment at presentation of HSPN. But there were no children who developed end-stage renal disease within observation period.

Results:

 

The most common histologic findings were grades II (pure mesangial proliferation) and grade IIIA (focal segmental mesangial proliferation with occasional crescents and adhesions) of the International Study of Kidney Disease in Children classification (11 and 10 cases respectively). In one case, crescents formation was observed in more than 75% of the glomeruli (grade V). And two children had membranoproliferative pattern of injury (grade VI). There were expression of immunoglobulins M and G in 13 cases, but it didn’t correlate with any clinical or morphological findings. There was no relationship between the severity of proteinuria and pathologic grading. The presence of crescents in the first biopsy didn’t correlate with the severity of renal failure. We found a significant correlation between the severity of renal involvement and degree of interstitial fibrosis and tubular atrophy in HSPN.

Conclusions:

 

Crescent formation is not associated with kidney failure progression in children HSPN. Our results suggest that renal impairment severity is probably related to degree of tubulointerstitial damage.