[Nephropathy in Schönlein-Henoch purpura: a retrospective study of the last 25 years]

Schönlein-Henoch purpura is a systemic vasculitis due to IgA-mediated hypersensitivity, almost exclusively affecting the pediatric age group. Long-term prognosis is mainly conditioned by renal involvement, which can appear at onset or during the course of the disease. To evaluate renal involvement, 764 patients with Schönlein-Henoch purpura were retrospectively reviewed. Of these, 153 (20 %) had renal involvement, the most frequent form of presentation being non-nephrotic hematuria/proteinuria (67 patients) followed by isolated hematuria (41 patients). Renal biopsy was performed in 39 patients, and the most frequent pathological findings were diffuse mesangial proliferation with IgA deposits and less than 50 % of crescentic glomeruli. Treatment was not curative. Three patients (2 %) progressed to end-stage renal failure and required renal transplantation. One patient died. Notably, two of the patients who underwent renal transplantation had disease recurrence. We stress that nephropathy is usually benign and that it requires long-term follow-up.