Four-year prognosis of multidrug combination therapy for Henoch-Schönlein purpura nephritis

Abstract

The long-term renal prognosis of Henoch-Schönlein purpura nephritis (HSPN) in children and the pathological changes before and after treatment has not yet been clarified, and the optimal treatment for HSPN remains unclear. In Japan, children with HSPN are treated according to the treatment guidelines for childhood immunoglobulin A nephropathy. Our study included 8 patients with HSPN who received multidrug combination therapy with azathioprine. All patients underwent renal biopsy at presentation, and 7 patients underwent follow-up biopsy after therapy. Four years after initiating treatment, no patients had decreased renal function compared to that pretreatment and 2 patients had proteinuria (urine protein-to-creatinine ratio: 0.15 – 0.5 g/gCr). Follow-up renal biopsy revealed chronic lesions in 3 patients, but there was no correlation between chronic lesions and remnant proteinuria. Multidrug combination therapy with azathioprine has certain therapeutic efficacy in alleviating HSPN in children.