Universität zu Köln

Hennies, Imke, Gimpel, Charlotte, Gellermann, Jutta, Moeller, Kristina, Mayer, Brigitte, Dittrich, Katalin, Buescher, Anja K., Hansen, Matthias, Aulbert, Wiebke, Wuehl, Elke, Nissel, Richard, Schalk, Gessa, Weber, Lutz T., Pohl, Michael, Wygoda, Simone, Beetz, Rolf, Klaus, Guenter, Fehrenbach, Henry, Konig, Sabine, Staude, Hagen, Beringer, Ortraud, Bald, Martin, Walden, Ulrike, von Schnakenburg, Christian, Bertram, Gunhard, Wallot, Michael, Haeffner, Karsten, Wiech, Thorsten ORCID: 0000-0003-4053-1474, Hoyer, Peter F. and Pohl, Martin (2018). Presentation of pediatric Henoch-Schonlein purpura nephritis changes with age and renal histology depends on biopsy timing. Pediatr. Nephrol., 33 (2). S. 277 - 287. NEW YORK: SPRINGER. ISSN 1432-198X

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Abstract

This study correlates the clinical presentation of Henoch-Schonlein purpura nephritis (HSPN) with findings on initial renal biopsy. Data from 202 pediatric patients enrolled in the HSPN registry of the German Society of Pediatric Nephrology reported by 26 centers between 2008 and 2014 were analyzed. All biopsy reports were re-evaluated for the presence of cellular crescents or chronic pathological lesions (fibrous crescents, glomerular sclerosis, tubular atrophy > 5%, and interstitial fibrosis > 5%). Patients with HSPN with cellular glomerular crescents were biopsied earlier after onset of nephritis (median 24 vs 36 days, p = 0.04) than those without, whereas patients with chronic lesions were biopsied later (57 vs 19 days, p < 0.001) and were older (10.3 vs 8.6 years, p = 0.01) than those without. Patients biopsied more than 30 days after the onset of HSPN had significantly more chronic lesions (52 vs 22%, p < 0.001), lower eGFR (88 vs 102 ml/min/1.73m(2), p = 0.01), but lower proteinuria (2.3 vs 4.5 g/g, p < 0.0001) than patients biopsied earlier. Children above 10 years of age had lower proteinuria (1.98 vs 4.58 g/g, p < 0.001), lower eGFR (86 vs 101 ml/min/1.73m(2), p = 0.002) and were biopsied significantly later after onset of nephritis (44 vs 22 days, p < 0.001) showing more chronic lesions (45 vs 30%, p = 0.03). Proteinuria and renal function at presentation decreased with age. In summary, we find an age-dependent presentation of HSPN with a more insidious onset of non-nephrotic proteinuria, impaired renal function, longer delay to biopsy, and more chronic histopathological lesions in children above the age of 10 years. Thus, HSPN presents more like Immunoglobulin A (IgA) nephritis in older than in younger children.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Hennies, Imke UNSPECIFIED UNSPECIFIED UNSPECIFIED Gimpel, Charlotte UNSPECIFIED UNSPECIFIED UNSPECIFIED Gellermann, Jutta UNSPECIFIED UNSPECIFIED UNSPECIFIED Moeller, Kristina UNSPECIFIED UNSPECIFIED UNSPECIFIED Mayer, Brigitte UNSPECIFIED UNSPECIFIED UNSPECIFIED Dittrich, Katalin UNSPECIFIED UNSPECIFIED UNSPECIFIED Buescher, Anja K. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hansen, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Aulbert, Wiebke UNSPECIFIED UNSPECIFIED UNSPECIFIED Wuehl, Elke UNSPECIFIED UNSPECIFIED UNSPECIFIED Nissel, Richard UNSPECIFIED UNSPECIFIED UNSPECIFIED Schalk, Gessa UNSPECIFIED UNSPECIFIED UNSPECIFIED Weber, Lutz T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pohl, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Wygoda, Simone UNSPECIFIED UNSPECIFIED UNSPECIFIED Beetz, Rolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Klaus, Guenter UNSPECIFIED UNSPECIFIED UNSPECIFIED Fehrenbach, Henry UNSPECIFIED UNSPECIFIED UNSPECIFIED Konig, Sabine UNSPECIFIED UNSPECIFIED UNSPECIFIED Staude, Hagen UNSPECIFIED UNSPECIFIED UNSPECIFIED Beringer, Ortraud UNSPECIFIED UNSPECIFIED UNSPECIFIED Bald, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Walden, Ulrike UNSPECIFIED UNSPECIFIED UNSPECIFIED von Schnakenburg, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Bertram, Gunhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Wallot, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Haeffner, Karsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Wiech, Thorsten UNSPECIFIED orcid.org/0000-0003-4053-1474 UNSPECIFIED Hoyer, Peter F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pohl, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-198259
DOI:	10.1007/s00467-017-3794-1
Journal or Publication Title:	Pediatr. Nephrol.
Volume:	33
Number:	2
Page Range:	S. 277 - 287
Date:	2018
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-198X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CHILDHOOD IGA NEPHROPATHY; OXFORD CLASSIFICATION; CONTROLLED-TRIAL; PULSE THERAPY; FOLLOW-UP; CHILDREN; METHYLPREDNISOLONE; LESIONS; RISK Multiple languages Pediatrics; Urology & Nephrology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/19825