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Pol. Merkur. Lek (Pol. Med. J.), 2020, XLIX/290: 099-102 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2020, XLIX/290: 099-102

Title: Schönlein-Henoch purpura – single-center, retrospective analysis of the diagnostic process, treatment and course in adults 

Authors: Konieczniak K, Wantoch Rekowski F, Gładyś A, Zugaj P, Rymarz A, Niemczyk S.

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SUMMARY IN POLISH & ENGLISH. FULL ARTICLE ONLY IN ENGLISH.

Schönlein-Henoch purpura – single-center, retrospective analysis of the diagnostic process, treatment and course in adults

Konieczniak K, Wantoch Rekowski F, Gładyś A, Zugaj P, Rymarz A, Niemczyk S.

Department of Internal Disease, Nephrology and Dialysotherapy, Military Institute of Medicine, Warsaw, Poland

Henoch-Schönlein-purpura (HSP) is a type of systemic vasculitis characterized by increased serum levels of IgA and the deposition of immune complexes mainly composed of IgA1. The cause of this disease has not yet been known. HSP mainly affects the pediatric population. In adults it is associated with a more aggressive course. A characteristic symptom of most patients is a petechial rash, often coexisting with joint pain and abdominal pain.
The aim of the study
was to present the clinical picture and therapeutic possibilities of adult patients diagnosed with HSP.
Material and methods
. A retrospective study was carried out in 8 adult patients with HSP, including 3 women and 5 men. The course of the disease, the degree of kidney damage and the effectiveness of the treatment were analyzed.
Results
. The mean value of nitrogen retention indexes in the studied group of patients was increased (creatinine: 1.47 ± 0.3 mg/dl, urea: 54.45 ± 9.02 mg/dl), no significant deviations were found in blood counts. In the general urine examination, hematuria was noted in 7 of 8 patients, proteinuria in 6 patients. Daily proteinuria was significantly increased (2498 ± 1031.69 mg/24h). 7 out of 8 patients had a diagnostic kidney biopsy. In 6 patients, the immunomorphological picture indicated glomerulonephritis in the course of IgA nephropathy. Six (75%) patients received immunosuppressive treatment, two (25%) conservative treatment.
Conclusions
. The one-center retrospective one-year analysis of patients diagnosed with HSP shows that IgA-related vasculitis is a disease with a varied course, often causing diagnostic as well as therapeutic difficulties.

Key words: Henoch-Schönlein purpura, vasculitis, IgA nephropathy, immunosuppression, renal failure

Pol Med J, 2021; XLIX (290); 99–102