Xueqian Li1,2,3,4, Mengmeng Tang1,2,3,4, Xingfeng Yao4,5, Nan Zhang4,5, Jianfeng Fan1,2,3,4, Nan Zhou1,2,3,4, Qiang Sun1,2,3,4, Zhi Chen1,2,3,4, Qun Meng1,2,3,4, Lei Lei1,2,3,4, Hejia Zhang1,2,3,4, Chen Ling1,2,3,4, Lin Hua6, Xiangmei Chen7, Xiaorong Liu8,9,10,11. 1. Department of Nephrology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China. 2. Beijing Children's Hemodialysis Center, Beijing, 100045, China. 3. Beijing Key Laboratory of Pediatric Chronic Kidney Disease and Blood Purification, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China. 4. National Center for Children's Health, Beijing, 100045, China. 5. Department of Pathology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China. 6. Biostatistics and Bioinformatics, School of Biomedical Engineering, Capital Medical University, Beijing, 100069, China. 7. Department of Nephrology, Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, 28th Fuxing Road, Beijing, 100853, China. 8. Department of Nephrology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China. lxrbch@sina.com. 9. Beijing Children's Hemodialysis Center, Beijing, 100045, China. lxrbch@sina.com. 10. Beijing Key Laboratory of Pediatric Chronic Kidney Disease and Blood Purification, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China. lxrbch@sina.com. 11. National Center for Children's Health, Beijing, 100045, China. lxrbch@sina.com.
Abstract
BACKGROUND: There is controversy over whether IgA nephropathy (IgAN) and Henoch-Schönlein purpura nephritis (HSPN) are the same diseases. This study focuses on the clinicopathological comparison between HSPN and IgAN in children. METHODS: Children with IgAN and HSPN who had a diagnostic renal biopsy were enrolled. This study collected the clinical data of patients at biopsy, re-evaluated the pathological lesions of patients according to the Oxford Classification (MEST-C), and made a retrospective comparison between IgAN and HSPN on different stratifications of the course (Tc) and proteinuria. RESULTS: A total of 142 children with IgAN and 57 children with HSPN were enrolled. Various stratification showed the same result, which suggested that IgAN showed more mesangial proliferation (M). HSPN showed more segmental glomerulosclerosis in the Tc > 12 m group than IgAN (S 60.0% vs. 9.10%, P = 0.008). In the non-nephrotic-range and nephrotic-range proteinuria group, there were no significant differences in MEST-C scores between IgAN and HSPN. CONCLUSION: M is more common in IgAN. HSPN had more S than IgAN over the course of more than 12 months. These results indicate the differences in the pathogenesis in IgAN and HSPN. We propose early biopsy and active treatment of HSPN within 12 months to delay the development of chronic lesions.
BACKGROUND: There is controversy over whether IgA nephropathy (IgAN) and Henoch-Schönlein purpura nephritis (HSPN) are the same diseases. This study focuses on the clinicopathological comparison between HSPN and IgAN in children. METHODS:Children with IgAN and HSPN who had a diagnostic renal biopsy were enrolled. This study collected the clinical data of patients at biopsy, re-evaluated the pathological lesions of patients according to the Oxford Classification (MEST-C), and made a retrospective comparison between IgAN and HSPN on different stratifications of the course (Tc) and proteinuria. RESULTS: A total of 142 children with IgAN and 57 children with HSPN were enrolled. Various stratification showed the same result, which suggested that IgAN showed more mesangial proliferation (M). HSPN showed more segmental glomerulosclerosis in the Tc > 12 m group than IgAN (S 60.0% vs. 9.10%, P = 0.008). In the non-nephrotic-range and nephrotic-range proteinuria group, there were no significant differences in MEST-C scores between IgAN and HSPN. CONCLUSION: M is more common in IgAN. HSPN had more S than IgAN over the course of more than 12 months. These results indicate the differences in the pathogenesis in IgAN and HSPN. We propose early biopsy and active treatment of HSPN within 12 months to delay the development of chronic lesions.
Entities:
Keywords:
Children; Clinicopathological; Henoch–Schönlein purpura nephritis; IgA nephropathy; Kidney biopsy; The Oxford classification
Authors: R Counahan; M H Winterborn; R H White; J M Heaton; S R Meadow; N H Bluett; H Swetschin; J S Cameron; C Chantler Journal: Br Med J Date: 1977-07-02
Authors: Hitoshi Suzuki; Krzysztof Kiryluk; Jan Novak; Zina Moldoveanu; Andrew B Herr; Matthew B Renfrow; Robert J Wyatt; Francesco Scolari; Jiri Mestecky; Ali G Gharavi; Bruce A Julian Journal: J Am Soc Nephrol Date: 2011-09-23 Impact factor: 10.121
Authors: Krzysztof Kiryluk; Zina Moldoveanu; John T Sanders; T Matthew Eison; Hitoshi Suzuki; Bruce A Julian; Jan Novak; Ali G Gharavi; Robert J Wyatt Journal: Kidney Int Date: 2011-02-16 Impact factor: 10.612