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Henoch-Schönlein nephritis associated with streptococcal infection and persistent hypocomplementemia: a case report
Francisco Rivera1, Sara Anaya, Javier Pérez-Alvarez
1Sección de Nefrología, Hospital General de Ciudad Real, c/Tomelloso s/n, 13005 Ciudad Real, Spain. friverahdez@telefonica.net.
Journal of Medical Case Reports
|February 26, 2010
Summary
Henoch-Schönlein purpura, a kidney-affecting disease, can follow streptococcal infections. This case highlights persistent low complement levels and successful treatment with steroids and ACE inhibitors for this rare presentation.
Area of Science:
- Pediatric Nephrology
- Immunology
- Rheumatology
Background:
- Henoch-Schönlein purpura (HSP) is a systemic vasculitis characterized by IgA deposition in the mesangium, frequently involving the kidneys.
- Streptococcal infections can trigger abnormal immune responses, mimicking HSP and acute post-infectious glomerulonephritis.
- Hypocomplementemia, common in glomerulonephritis, has also been observed in HSP.
Purpose of the Study:
- To report a unique case of Henoch-Schönlein purpura with specific clinical and laboratory findings.
- To discuss the potential link between streptococcal infection, complement abnormalities, and HSP.
- To evaluate the efficacy of specific treatments in a complex HSP case.
Main Methods:
- Case presentation of a 14-year-old girl with post-streptococcal purpura and urinary abnormalities.
- Renal biopsy confirming Henoch-Schönlein purpura nephritis.
- Monitoring of persistent hypocomplementemia (low C4 levels) and clinical response to treatment.
Main Results:
- The patient presented with HSP following a streptococcal infection.
- Persistent hypocomplementemia (low C4) was noted despite clinical improvement.
- Successful treatment response to enalapril (an ACE inhibitor) and steroids was observed, even with nephrotic syndrome.
Conclusions:
- Henoch-Schönlein purpura can be triggered by streptococcal infections in individuals with underlying complement abnormalities.
- Persistent hypocomplementemia is a notable feature in some HSP cases.
- Steroids and ACE inhibitors may be effective treatments for HSP presenting with nephrotic syndrome and complement dysregulation.
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