Revista: | Revista de nefrología, diálisis y transplante |
Base de datos: | PERIÓDICA |
Número de sistema: | 000398188 |
ISSN: | 0326-3428 |
Autores: | Rahman, Ricardo C1 Suarez, Angela del Carmen1 Amoreo, Oscar1 |
Instituciones: | 1Hospital de Niños "Superiora Sor María Ludovica", La Plata, Buenos Aires. Argentina |
Año: | 2006 |
Volumen: | 26 |
Número: | 4 |
Paginación: | 169-174 |
País: | Argentina |
Idioma: | Español |
Tipo de documento: | Artículo |
Enfoque: | Descriptivo |
Resumen en español | La púrpura deSchonlein Henoch (PSH) es la vasculitis pediatría. Un 30 a 70% padecen nefritis. éta:'i!lsuficilencia renal, la proteinuria masiva y las semiluciones marcadores desfavorables. Aunque el pronóstico bueno, la nefritis severa es la principal De 41 niños con PSH y proteisometidos a biopsia renal, en 36 se evaluó 'nf>,,,tnr,,rrlpnTP la evolución alejada> 6 meses (X: 4, varones con una edad promedio de 8,7 ingreso 23 tenían hematuria macroscópica y 10 X: 167 mg/kg./día; clearance de creaml/ml1,73 m2 (8<80). Las 36 biopsias (clasificación de Emancipator): Ha (6), (lO), I1Ib (lO), IVb (2), VI (1), esclerosis (1) 'll'.l'Jl1~l~ (1). Treinta y uno fueron tratados, tocorticoides, 21 ciclofosfamida/azatioprina U5,"wuL, antiagregantes, e IgG endoo descendió significativamente la a 17,37 mg/kg./día (sólo en 4 persistió los 11 que persistieron con proteinuria atamiento fue más tardío (X:8,81m). Los la proieinuria y 2/2 el filtrado a un compromiso histológico de que una terapéutica agresiva efectividad p |
Resumen en inglés | Henoch Schonlein purpura (HSP) is the most frequent vasculitis in childhood. Renal involvement, ranging from 30 to 70%, has long been recognized as a potentíal complication, especially when heavy proteinuria, renal failure, hypertension or glomerular crescents are present. The aim of this retrospective study was to analyze the outcome (X: 4.45 years) of 36 out of 41 HSP nephritis with heavy proteinuria, aged X 8.7 years, treated and followed in our pediatric nephrology department. At diagnosis they showed macroscopic hematuria in 23 and hypertension in 10, heavy proteinuria (X: 167 mg/kg/ day), creatinine clearance X: 103.24 ml/ml1,73 m2 (8 <80). Microscopic examination showed the following histologic classes (Emancipator): Ha (6), Ilb (5), I1Ia (lO), IlIb (lO), IVb (2), VI (1), sclerosis (1) and mesangiolysis (1). Thirty one were treated, al! of them with corticosteroids, 21 received cyclophosphamide / azathioprine, and sorne of them anticoagulants, dipyridamole, and intravenous IgG. Five did not-receivedanytreatment. 68% of those treated and 20% of not.treated showed crescentic involvement. The outcome was favorable in most of them: 87% of those who received therapy decreased ornormalized proteinuria (from 167 a 17.37 mg/kg/day (heavy proteinuria persisted only in 4). FroIli8'paileniswithl()~ renal function 2 developed chronic renal failure. Six persisted with hypertension. In most of them ear1y therapy was administrated (X: 3;83m),lnll-with persistent-proteinuria and in one withchroriicrenal failiire, therapy was instituted later(X: 8.81m). Those 5, who did not received therapy normalized proteinuria and 2/2 their glomerular filtration rateo Their good evolution was probably due to a less severe histological compromise |
Disciplinas: | Medicina |
Palabras clave: | Nefrología, Pediatría, Nefritis, Proteinuria, Niños, Púrpura de Henoch-Schönlein |
Keyword: | Medicine, Nephrology, Pediatrics, Schönlein-Henoch purpura, Nephritis, Proteinuria, Children |
Texto completo: | Texto completo (Ver PDF) |