Abstract
We experienced a purpura nephritis case with histological findings of membranoproliferative glomerulonephritis of ISKDC grade VI, for which frequent steroid pulse therapy was effective. A 12-year-old boy experienced the complication of nephrotic syndrome at the time of developing purpura nephritis and showed histopathological findings of membranoproliferative glomerulonephritis. His prognosis was considered to be poor. When three courses of steroid pulse therapy, in addition to multidrug combination therapy, were administered, followed by two further courses, the patient experienced partial remission. Therefore, he was discharged from the hospital, and outpatient treatment was continued. Because both proteinuria and hematuria resolved, gradual tapering and eventual withdrawal of the steroid were performed. Administration of other drugs was also discontinued. To date, no recurrence of nephritis has been observed. Renal biopsy prior to drug withdrawal showed ISKDC grade II, indicating remission. The renal prognosis in cases of purpura nephritis complicated by nephrotic syndrome and/or with findings of membranoproliferative glomerulonephritis is considered to be poor. Though there are currently no appropriate treatments for these conditions, our current experience suggests frequent steroid pulse therapy to possibly be effective.
