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Journal of the Korean Society of Pediatric Nephrology 2000;4(2): 120-126.
소아 Henoch-$Sch{ddot{o}}nlein$ 신염의 추적 관찰
장희숙, 홍인희, 고철우, 구자훈, 곽정식
1경북대학교 의과대학 소아과학교실
2경북대학교 의과대학 소아과학교실
3경북대학교 의과대학 소아과학교실
4경북대학교 의과대학 소아과학교실
5경북대학교 의과대학 병리학교실
Henoch-$Sch{ddot{o}}nlein$ Nephritis in Children
Hee-Suk Jang, In-Hee Hong, Cheol-Woo Go, Ja-Hun Koo, Jung-Sik Kwak
1Department of Pediatrics, Kyungpook National University, College of Medicine
2Department of Pediatrics, Kyungpook National University, College of Medicine
3Department of Pediatrics, Kyungpook National University, College of Medicine
4Department of Pediatrics, Kyungpook National University, College of Medicine
5Department of Pathology, Kyungpook National University, College of Medicine
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ABSTRACT
Purpose : This retrospective study has been undertaken to find out the clinical outcome of children with HS nephntis and its relationship with initial clinical presentation and/or renal pathologic finding. Patients and methods : Study population consisted of 59 children with HS nephritis who have been admitted to the Pediatric department of Kyungpook University Hospital from 1987 to 1999, and biopsy was done with indications of heavy proteinuria (> 1 g/m2/day) lasting over 1 month, nephrotic syndrome, and persistent hematuria and/or proteinuria over 1 year. Patients were divided clinically into 3 groups ; isolated hematuria, hematuria with proteinuria and heavy proteinuria (including nephrotic syndrome). Biopsy findings ore graded from I-V according to International Study of Kidney Disease in Children (ISKDC).
Results : Mean age of presentation was $8.1{pm}3.0$ years and slight male preponderance m noted (33 boys md 26 girls). Histopathologic grading showed Grade I ; 2, Grade II ; 44, and Grade III ; 13 cases. Clinical outcome at the follow-up period of 1-2 year (49 cases) and 3-4 years (30 cases) shooed normal urinalysis in 75 (30.6$%$) and 18 cases (60.0$%$), persistent isolated hematuria in 20 (40.8$%$) and 2 cases (6.7$%$), hematuria with proteinuria in 11 (22.5$%$) and 8 cases (26.6$%$), and persistent heavy proteinuria in 3 (6.1$%$) and 2 cases (6.7$%$) respectively. Clinical outcome according to histopathologic grading showed the frequency of normalization of urinalysis being lower in Grade III compared to grade I or II. Clinical outcome according to initial clinical presentation showed no relationship to the normalization or urinalysis at follow-up periods. However, 15-20$%$ of children with initial heavy proteinuria showed persistent heavy proteinuria (3 out of 20 cases at 1-2 years, and 2 out of 10 case at 3-4 years of follow-up periods).
Conclusion : The majority of children with HS nephritis (histopathologic grade I, II, III) improved within 3-4 years and persistent heavy proteinuria was seen only in a kw of children with initial clinical presentation of heavy proteinuria.
Key words: Clinical Outcome of HS Nephritis
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