Korean Journal of Nephrology 1994;13(4):870-878.

성인 Henoch - Schoenlein 신염 환자의 임상상및 병리학적 특성

나기영 , 허우성 , 진호준 , 윤형진 , 안규리 , 한진석 , 김성권 , 이정상

Abstract

Renal involvement is the most important prognostic factor in Henoch Schoenlein purpura. There are few reports about adult Henoch Schoenlein nephritis compared with childrens cases. We retrospectively analyzed the clinical and patho- logic data of 32 patients with biopsy proven Henoch Schoenlein nephritis examined at Seoul National Uni- versity Hospital. And the results were as follows. 1) 75% patients were younger than 30 and the male to female ratio was 20: 12. 2) Abdominal pain was observed in 28(88%), Gastrointestinal bleeding in 8(25 % ) and arthralgia in 19(59%). Of these, 7 patients had all triads. 3) Ther clinical syndrome at presentation was asymptomatic urinary abnormality in 16, chronic glomerulonephritis in 7, nephrotic syndrome in 5 and acute glomerulonephritis in 4 patients. 4) Serum IgA level was elevated in 14(50%). Serum complement level was all normal. 5) The pathologic diagnosis according to ISKDC classification was grade III in 24(75%), grade II in 5(16%), grade IV in 2(6%) grade V in 1(3%). 6) According to Meadows classification, out of 21 patients who were followed up more than 6 months, 5 were classified as stage A, 7 as stage B, 5 as stage C and 4 as stage D. These findings suggest that nephrotic syndrome at presentation, high pathologic grade and initial azotemia are poor prognostic factors.