Schönlein-Henoch nephritis and IgA nephropathy in children

When Schönlein-Henoch nephritis presents with more than just microhematuria, only 72% of cases go on to complete recovery. Evidence of renal disease may reappear after apparent complete recovery. Schönlein-Henoch nephritis may be the single commonest form of crescentic glomerulonephritis, accounting for 30% of cases. Prednisone for 2 weeks may prevent Schönlein-Henoch nephritis in children who do not already have it when first seen. IgA nephropathy was found in 8% of children with isolated proteinuria and has been reported with human immunodeficiency virus infection. Heavy proteinuria at onset, focal sclerotic and tubulointerstitial changes, and crescents and capsular adhesions are poor prognostic indicators. The prognostic significance of hypertension and of the absence of gross hematuria remains uncertain. After a follow-up of at least 8 years, 53% of patients are clinically in remission. In a short-term double-blind, crossover trial, prednisone had no effect on IgA nephropathy. Recent advances do not yet lead to a unifying concept of the pathogenesis of Schönlein-Henoch nephritis or IgA nephropathy.