Five-Year Experience of Henoch-Schönlein Nephritis in Thai Children: A Single Center Report

Background: The risk of Henoch-Schönlein nephritis (HSN) is well-established, however, the existing data validating this concept remains limited. Materials and Methods: A retrospective 5-year chart review was conducted at Queen Sirikit National Institute of Child Health. Results: Ninety patients were diagnosed with Henoch-Schönlein purpura, with a mean age of 6.9±2.8 years. Among them, 25 cases (27.7%) presented with renal involvement or HSN. Among the HSN cases, 17 were classified as mild and eight as severe. Symptom presentation included hematuria in ten cases (40%), proteinuria with hematuria in six cases (24%), nephrotic range proteinuria with hematuria in four cases (16%), acute nephritis syndrome with proteinuria in three cases (12%), proteinuria in one case (4%), and nephrotic range proteinuria in one case (4%). Significant associations were observed between HSN incidence and patients older than eight years, (p=0.03) and those with purpura lasting more than three weeks, (p=0.02). The onset of renal involvement ranged from 1 to 315 days (mean of 45.4 days and median of 24 days). Three cases (12%) had mild HSN after six months of the onset of disease. There were no reported cases of mortality or chronic kidney disease. Conclusion: The majority of HSN cases manifest as mild and are associated with favorable outcomes. To achieve early diagnosis of HSN in all instances, it is imperative to conduct timely and regular urinary examinations for all affected patients. Keywords: Henoch-Schönlein purpura; Henoch-Schönlein nephritis; Nephrotic syndrome; Hematuria