Comparative analysis of clinicopathological findings and outcome of Henoch-Schonlein nephritis and IgA nephropathy in adults

To compare the clinicopathological findings and prognosis of Henoch-Schonlein nephritis (HSPN) and IgA nephropathy (IgAN) in adults.We enrolled 31 patients with HSPN and 62 patients with IgAN in the present study. They were followed up for 47+/-23 months and 47+/-20 months respectively, and their clinical manifestations and renal pathological findings were collected. Renal pathological changes were semiquantitatively graded.The clinical manifestations, including hypertension, excretion of serum creatinine and urinary protein, were similar in patients with HSPN and IgAN [38.7% vs 27.4%, (121+/-164) vs (106+/-43) micromol/L, (3.2+/-3.1) vs (2.8+/-2.9) g/d, P>0.05]. Renal pathological investigation showed endothelial proliferation in 40.6% (13/31) of HSPN patients and 19.4% (12/62) of IgAN patients and the difference was significant (P=0.021). In patients with IgAN, the tubulointerstitial chronicity index was higher than that in HSPN (2 vs 1, P=0.009), but there were no statistically significant differences in crescent formation(including segmental glomerular necrosis) and glomerular sclerosis(1 vs 0, 1 vs 1, P>0.05). In patients with HSPN capillary wall staining for IgA was more frequently found than in IgAN (71.0% vs 43.5%, P=0.013). With creatinine level doubling as the end point, the follow-up data indicated that the renal survival was 87.1% in HSPN and 91.9% in IgAN and there was no statistically significant difference between HSPN and IgAN (P=0.481).Although significant pathological difference was found between HSPN and IgAN, the renal clinical manifestations and long term outcome were similar between the two diseases in adults.PubMed05458-613