Study on 10 heavy proteinuria cases of HSPN with good susceptibility toward combination therapy

Abstract

We examined 10 pediatric heavy proteinuria cases of Henoch-Schönlein purpura nephritis (HSPN). They all showed good clinical course by using combination therapy including steroid, ACEI and ARB. Eight patients continuously showed heavy proteinuria (urinary protein excretion of >1.0 g/day/m² body surface area or urine protein-creatinine ratio in the first morning urine of >1.0 g/g) for longer than 1–2 months, and 2 patient showed hypoalbuminemia of < 3.0 g/dL at the onset. Their proteinuria disappeared relatively smoothly after the introduction of treatment. The pathological findings on second renal biopsy revealed improvement in all cases. The close observation for longer than 18 months has been carried out after the cessation of steroid administration. No proteinuria has appeared since then. This study indicates a possibility of effectiveness of combination therapy including steroid, ACEI and ARB for HSPN patients with severe proteinuria.