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Severe Henoch-Schönlein nephritis: resolution with azathioprine and steroids
Surjit Singh1, Devidayal, Lata Kumar
1Department of Pediatrics, Advanced Pediatric Center, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India. surjitsingh@i91.net.in
Aim:
The aim of this study was to assess the efficacy of long-term azathioprine and steroids for treatment of severe nephritis in children with Henoch-Schönlein purpura (HSP).
Methods:
Analysis of case records of children with HSP followed up for a mean duration of 4.7 years (range 6 months-6.5 years) was performed. All underwent clinical status evaluation followed by percutaneous kidney biopsies. Renal histological changes were graded according to the International Study of Kidney Disease in Childhood (ISKDC) classification. Nine children with severe nephritis (grades III and IV) received steroids (mean duration 12.1 months) and long-term azathioprine (mean duration 14.7 months), while two children received steroids alone.
Results:
All nine children in the former category showed sustained clinical and biochemical remission, while the two children in the latter category did not.
Conclusion:
Severe nephritis seen in association with HSP can be effectively treated with a combination of azathioprine and steroids.