Clinical and Pathological Analysis of Childhood Henoch-Schonlein Purpura Nephritis with Nephritic Syndrome

Abstract：Objective:To investigate the relationship between clinical and renal pathologic in childhood Henoch-Schonlein purpura nephritis with nephritic syndrome.Method:Retrospective review of the clinical data and renal pathologic of 16 cases of childhood Henoch-Schonlein purpura nephritis with nephritic syndrome who had been performed renal biopsy.Result:(1) Among the pathological grading of glomeruli, we found grade Ⅲb 14 cases (87.5%), gradeⅡb and grade Ⅳb 1 case respectively (6.25%).7 cases were macrohematuria including grade Ⅲb(6 cases,85.7%) and grade Ⅳb(1 case,14.3%).9 cases were microhematuria including grade Ⅲb(8 cases,89.0%) and gradeⅡb(1 case,11.0%).Among 9 cases renal damage of tubulointersitial,there were 6 cases(66.7%) with macrohematuria and 3 cases with microhematuria.(2)Diffuse mesangial proliferation(13 cases,81.25% ) was the most common pathological pattern,7 cases were combining with crescent(macrohematuria 85.7%),4 cases were endocapillary proliferation(macrohematuria 75.0%),4 cases were capillary loops necrosis(macrohematuria 75.0%).(3)IgA+IgM as same as IgA+IgG+IgM deposit(43.75%) was the most common immune pathological grade Ⅲb andⅣb.Conclusion:Renal pathological grade Ⅲ is the most common type in childhood Henoch-Schonlein purpura nephritis with nephritic syndrome,which is often associated with severe clinical manifestations and pathological changes.Early renal biopsy is very important to make treatment plan.