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The significance of tubulointerstitial lesions in childhood Henoch-Sch?nlein nephritis

 Beom Jin Lim  ;  Jae Il Shin  ;  Sung-eun Choi  ;  Hyechang Rhim  ;  Jae Seung Lee  ;  Pyung Kil Kim  ;  Hyeon Joo Jeong  ;  Ji Hong Kim 
 PEDIATRIC NEPHROLOGY, Vol.31(11) : 2087-2093, 2016 
Journal Title
Issue Date
Biopsy ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Immunoglobulin G/immunology ; Immunoglobulin G/metabolism ; Immunosuppressive Agents/therapeutic use* ; Kidney/pathology* ; Male ; Nephritis, Interstitial/blood ; Nephritis, Interstitial/drug therapy* ; Nephritis, Interstitial/immunology ; Nephritis, Interstitial/pathology* ; Proteinuria/urine ; Purpura, Schoenlein-Henoch/blood ; Purpura, Schoenlein-Henoch/drug therapy* ; Purpura, Schoenlein-Henoch/immunology ; Purpura, Schoenlein-Henoch/pathology* ; Retrospective Studies ; Serum Albumin/analysis
Henoch–Schönlein nephritis ; duration of heavy proteinuria ; mesangial IgA deposits ; tubulointerstitial lesions
BACKGROUND: Little information is currently available on the development of tubulointerstitial lesions in children with Henoch-Sch?nlein nephritis (HSN). To identify the impact of the development of tubulointerstitial changes in HSN, we retrospectively analyzed renal biopsies obtained from children with HSN.

METHODS: Twenty-eight children with HSN from whom serial renal biopsies had been obtained before and after immunosuppressive therapy were enrolled in the study. The patients were divided into two groups according to the observed change in tubulointerstitial lesion development: group I (n?=?15), with stable or improved tubulointerstitial lesions, and group II (n?=?13), with worsened tubulointerstitial lesions. Group II patients had longer duration of proteinuria than group I patients (3.7?±?3.7 years vs. 1.7?±?1.7 years, p?=?0.052).

RESULTS: The change in serum albumin level was negatively correlated with the change in tubulointerstitial scores before and after treatment (γ?=?-0.444, p?=?0.018). Group II patients showed a significant decrease in immunoglobulin G (IgG) and IgA deposits after treatment (p?=?0.039 and 0.003, respectively), while group II patients did not (p?=?0.458 and 0.506, respectively).

CONCLUSIONS: Although the International Study of Kidney Disease in Children classification of HSN does not include tubulointerstitial lesions, they can progress during treatment and could have significant clinical implications in association with the duration of proteinuria.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ji Hong(김지홍) ORCID logo https://orcid.org/0000-0001-5352-5423
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
Lim, Beom Jin(임범진) ORCID logo https://orcid.org/0000-0003-2856-0133
Jeong, Hyeon Joo(정현주) ORCID logo https://orcid.org/0000-0002-9695-1227
Choi, Sung Eun(최성은) ORCID logo https://orcid.org/0000-0002-6955-658X
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