A Study On Clinical Features Of Adult Henoch-Sch?nlein Purpura Nephritis And Its Relationship With Renal Pathology

Objective:To investigate the clinical features of adult Henoch-Sch?nlein purpura nephritis and its relationship with renal pathology in order to provide a basis for clinical practice.Methods:A total of 56 adult HSPN patients diagnosed by clinical diagnosis and renal biopsy between January 2009 and June 2017 in Zunyi Medical College Hospital were collected.According to clinical manifestations and laboratory tests,performed clinical classification and ISKDC pathological grading and pathological type of renal tubulointerstitial,retrospectively analyzed the relationship between the clinical characteristics of adult HSPN patients treated in our hospital and the severity of renal pathology.Results:Adult HSPN patients included 26 females(46%)and 30 males(54%),with an average age of(22.8±13.8)years.All patients presented with different degrees of skin purpura.During the course of the disease,18 cases(32%)had double-limb edema,9 cases(16%)with abdominal type,6 cases(11%)with joint type,and 5 cases(9%)with abdominal type and joint type.54 cases(96%)had microscopic hematuria,23 cases(41%)had urinary protein<1.0 g/24h,24 cases(43%)had 1.0-3.5 g/24h,and 9 cases(16%)had>3.5 g/24h.Glomerular filtration rate(MDRD simplified formula):44 cases(79%)with eGFR≥90 ml/(min*1.73 m~2),10 cases(18%)with eGFR 60-89 ml/(min*1.73m~2),2 cases(3%)with eGFR<60 ml/(min*1.73m~2).Clinical classification:Hematuria and proteinuria in 47 cases(84%),nephrotic syndrome in 5 cases(9%),isolated proteinuria in 2 cases,1 case of acute nephritis,1 case of chronic nephritis.ISKDC pathological grade:Grade I in 1 case,Grade II in 8 cases(14%),Grade III in 46 cases(82%),Grade V in 1case.Tubulointerstitial pathology:-grade had 23 cases(41%),++grade had 32 cases(57%),and+++grade had only 1 case.Comparison of clinical parameters in different age groups:patients under age 18 had more extrarenal manifestations with abdominal types(20%).There was a positive correlation between age and the severity of renal tubulointerstitial lesions(r=0.508,P<0.05).There was a negative correlation between eGFR levels and age(r=-0.584,P<0.05).Conclusion:1.HSPN patients need to determine the degree of renal pathological damage combined with specific clinical features to generally evaluate disease condition and determine the patient’s therapeutic scheme.2.Age is an independent risk factor for HSPN.