Ankara Üniversitesi Tıp Fakültesi Mecmuası

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Ankara University

Pediatric Gastroenterology Pediatric Rheumatology

Çocuk Gastroenterolojisi Çocuk Romatolojisi

Erişkinlerde Henoch - Schonlein Purpurası (Renal Tutulumun Klinik, Laboratuvar ve Prognostik Ozellikleri)

Henoch-Schoénlein Purpura in the Adult (The Clinical, Laboratory and Prognostic Features of Renal Involvement)

Ateş

Kenan

ANKARA UNIVERSITY, ANKARA FACULTY OF MEDICINE

09 30 1992

45 3 565 580 07 01 1992 09 30 1992

1947

Ankara Üniversitesi Tıp Fakültesi Mecmuası

16 ila 67 yaş aralığındaki Henoch-Schénlein purpurası olan otuz sekiz yetişkin hasta retrospektif olarak incelendi. Böbrek tutulumu yirmi birinde (%55) mevcuttu ve 10 hastada (%48) asemptomatik hematüri ve/veya proteinüri, beş hastada (%24) akut nefritik sendrom, üç hastada (%14) nefrotik sendrom ve üç hastada (%14) kronik böbrek yetmezliği olarak görüldü. Böbrek tutulumu olmayan hastalar arasında klinik ve laboratuvar farkı yoktur.Ortalama 16,11 + 4,75 aylık bir takipten sonra, başlangıçta yalnızca hafif idrar anormallikleri olan hastaların nefritik sendrom, nefrotik sendrom veya böbrek yetmezliği olan hastalardan daha iyi durumda olduğunu bulduk. Başlangıçta böbrek tutulumunun daha şiddetli olduğu ve yaşlı hastalarda böbrek prognozunun daha kötü olduğu görülmektedir. Herhangi bir tedavi biçiminin böbrek prognozunu etkilemediğini bulduk.

Thirty-eight adult patients, aged from 16 to 67 years, with Henoch-Schénlein purpura were studied retrospectively. Renal involvement was present in twenty-one of them (55 %), and presented as asymptomatic hematuria and/or proteinuria in 10 patients (48 %), as acute nephritic syndrome in five patients (24 %), as nephrotic syndrome in three patients (14 %) and as chronic renal failure in three patients (14 %) There are not clinical and laboratory differences between the patients without renal involvement.After a mean follow-up of 16.11 + 4.75 months, we have been found that the patients with only mild urinary abnormalities at presentation do better than the patients with nephritic syndrome, nephrotic syndrome or renal failure. It seems that renal involvement at presentation has been more severe and renal prognosis has been poorer in older patients. We found that any form of therapy did not influence to renal prognosis.

Henoch-Schdnlein purpurasi BÖbrek tutulumu Prognoz

Henoch-Schénlein purpura Renal involvement Prognosis

1. Ballard HS Eisinger RP Gallo G : Renal manifestations of the Henoch-Schénlein syndrome in adults. Am J Med 49 : 328, 1970.

2. Buchanec J Galanda V Belakova S et al : Incidence of renal complications in Schénlein-Henoch purpura syndrome in dependence of an early administration of steroids. Int Urol Nephrol 20 : 409, 1988.

3. Cameron JS : Henoch-Schénlein purpura nephritis. In Textbook of Nephrology, Massry SG, Glassock RJ (eds). Second edition, Williams&Wilkins, Baltimore, 1989, pp 714-719.

4. Counahan R Winterborn MH White et al : Prognosis of Henoch-Schénlein nephritis in children. Br Med J 2: 11, 1977.

5. Cream JJ Gumpel JM Peachey RDG : Schénlein-Henoch purpura in the adult. QJM 39 : 461, 1970.

6. Fogazzi GB Pasquali S Moriggi M et al: Long-term outcome of Schénlein-Henoch nephritis in the adult, Clin Nephrol 31 : 60, 1989.

7. Knight JF Cameron JS : Henoch-Schénlein nephritis in adults. Nephrol Dial Transplant 2: 415, 1987.

8. Koskimies O Rapola J Savilahti E Vilska J : Renal involvement in SchénleinHenoch purpura. Acta Paediatr Scand 63 : 357, 1974.

9. Lee HS Koh HI Kim MJ Rha H : Henoch-Schénlein nephritis in adults : A clinical and morphological study. Clin Nephrol 26 : 125. 1976.

10. Levy M Broyer M Arsan A et al : Anaphylactoid purpura nephritis in childhood : Natural history and immunopathology. Adv Nephrol 6 : 183, 1978.

11. Li Volti S Mollica F : Henoch-Schénlein nephritis. Eur J Pediatr 148 : 378, 1989.

12. Meadow SR Glasgow EP White HR et al : Schénlein-Henoch nephritis. QJM 163 ; 241, 1972.

13. Roth DA Wilz DR Theil GB : Schénlein-Henoch syndrome in adults. QJM 55 : 145, 1985.

14. Waldo FB : Is Henoch-Schénlein purpura the systemic form of IgA nephropathy? Am J Kid Dis 12 : 373, 1988.

15. Wolff SM : The vasculitic syndromes. In Cecil Textbook of Medicine. Wyngaarden JB Smith LH (eds). 18th edition, WB Saunders Company, Philadelphia, 1988, pp 2025-2028.