The Clinical and Pathological Data Analysis of 108 Pediatric Patients With Henoch-Schonlein Purpura Nephritis

doi:10.3877/cma.j.issn.1673-5250.2014.06.024

Objective

To explore the clinical features and pathological types of Henoch-Schonlein purpura nephritis (HSPN) and their relationship in children.

Methods

From January 2009 to June 2013, the clinical and pathological data of 108 children with HSPN were retrospectively collected in the study. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of First People's Hospital of Liangshan Prefecture. Informed consent was obtained from each participants' parents.

Results

The haematuria and proteinuria (39 cases, 36.1 %) were the most common clinical types of HSPN, followed by nephritic syndrome (28 cases, 25.9 %), isolated proteinuria (14 cases, 13.0% ), isolated hematuria (12 cases, 11.1%), acute glomerulonephritis (10 case, 9.3% ), rapidly progressive glomerulonephritis (4 case,3.7%), chronic glomerulonephritis (1 case,0.9%). The majority pathological grade of HSPN were gradeⅡ (54 cases, 50.0 %) and grade Ⅲ (43 case, 39.8%). The pathological changes of hematuria and proteinuria type were mainly gradeⅡ (26 cases, 66.7%) and grade Ⅲ (9 cases, 23.1 %), and the pathological changes of nephritic syndrome type was grade Ⅲ (21 cases, 75.0%). There were no significant differences in pathological changes among isolated proteinuria, isolated hematuria, haematuria and proteinuria, and acute glomerulonephritis(P= 0.924). Meanwhile the pathological changes in nephritic syndrome type were more serious than those of above four clinical types (P< 0.01).

Conclusions

The severity of the clinic symptoms was not completely consistent with the pathological changes in pediatric patients with HSPN. The pathological changes was relatively serious in nephritic syndrome type.

Key words: Henoch-Schonlein purpura nephritis, Clinical type, Pathological, Child

表1 HSPN的临床类型与病理学分级的关系[n(%)]

Table 1 Relationship between clinical types and pathological classifications in HSPN [n(%)]

临床类型	例数	病理学分级
临床类型	例数	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	V级
孤立性血尿	12	1(8.3)	8(66.7)	3(25.0)	0(0.0 )	0 (0.0 )
孤立性蛋白尿	14	0(0.0)	10 (71.4)	4(28.6)	0(0.0 )	0 (0.0 )
血尿合并蛋白尿	39	3(7.7)	26(66.7)	9 (23.1)	1 (2.6)	0 (0.0 )
急性肾炎型	10	0(0.0)	6(60.0)	4(40.0 )	0 (0.0 )	0 (0.0 )
肾病综合征型	28	1(3.6)	4 (14.3)	21(75.0)	1 (3.6)	1 (3.6)
急进性肾炎型	4	0 (0.0 )	0 (0.0 )	2(50.0)	2(50.0)	0 (0.0 )
慢性肾炎型	1	0 (0.0 )	0 (0.0)	0 (0.0)	0 (0.0 )	1(100.0 )
合计	108	5(4.6)	54(50.0 )	43(39.8)	4 (3.7)	2 (1.9)

表1 HSPN的临床类型与病理学分级的关系[n(%)]

Table 1 Relationship between clinical types and pathological classifications in HSPN [n(%)]

临床类型	例数	病理学分级
临床类型	例数	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	V级
孤立性血尿	12	1(8.3)	8(66.7)	3(25.0)	0(0.0 )	0 (0.0 )
孤立性蛋白尿	14	0(0.0)	10 (71.4)	4(28.6)	0(0.0 )	0 (0.0 )
血尿合并蛋白尿	39	3(7.7)	26(66.7)	9 (23.1)	1 (2.6)	0 (0.0 )
急性肾炎型	10	0(0.0)	6(60.0)	4(40.0 )	0 (0.0 )	0 (0.0 )
肾病综合征型	28	1(3.6)	4 (14.3)	21(75.0)	1 (3.6)	1 (3.6)
急进性肾炎型	4	0 (0.0 )	0 (0.0 )	2(50.0)	2(50.0)	0 (0.0 )
慢性肾炎型	1	0 (0.0 )	0 (0.0)	0 (0.0)	0 (0.0 )	1(100.0 )
合计	108	5(4.6)	54(50.0 )	43(39.8)	4 (3.7)	2 (1.9)

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