Successful treatment of adult-onset Henoch-Schonlein purpura nephritis with high-dose immunoglobulins

被引：19

作者：

Kusuda, A ^{[1
]}

Migita, K ^{[1
]}

Tsuboi, M ^{[1
]}

Degawa, M ^{[1
]}

Matsuoka, N ^{[1
]}

Tominaga, M ^{[1
]}

Kawakami, A ^{[1
]}

Kawabe, Y ^{[1
]}

Taguchi, T ^{[1
]}

Eguchi, K ^{[1
]}

机构：

[1] Nagasaki Univ, Sch Med, Dept Internal Med 1, Nagasaki 8528501, Japan

来源：

INTERNAL MEDICINE | 1999年 / 38卷 / 04期

关键词：

nephrotic syndrome; steroid; anti-coagulant therapy;

D O I：

10.2169/internalmedicine.38.376

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

A 26-year-old woman was admitted for the evaluation of edema and massive proteinuria. She had a history of purpura of the lower extremities, abdominal pain and melena. Laboratory investigations showed hypoalbuminemia, hypercholesterolemia and proteinuria of over 10 g/day, Renal biopsy showed moderate proliferative glomerulonephritis with mesangial immunoglobulin A (IgA) deposition. She was diagnosed as having Henoch-Schonlein purpura nephritis. Oral prednisolone, dipyridamole and intravenous heparin treatment were not effective. Steroid pulse therapy induced a partial improvement of proteinuria to 2-3 g/day, High-dose intravenous immunoglobulin (IV-IG) treatment was introduced and a dramatic improvement of proteinuria was noted. IV-IG should be fully considered in patients with steroid-resistant Henoch-Schonlein purpura nephritis.

引用

页码：376 / 379

页数：4

共 20 条

[1] HENOCH-SCHONLEIN NEPHRITIS - PROGNOSTIC FEATURES AND THE CHALLENGE OF THERAPY [J].

AUSTIN, HA ;

BALOW, JE .

AMERICAN JOURNAL OF KIDNEY DISEASES, 1983, 2 (05) :512-520

[2] CLINICAL USES OF INTRAVENOUS IMMUNOGLOBULINS [J].

BERKMAN, SA ;

LEE, ML ;

GALE, RP .

ANNALS OF INTERNAL MEDICINE, 1990, 112 (04) :278-292

[3] Paradoxical and persistent renal impairment in Henoch-Schonlein purpura after high-dose immunoglobulin therapy [J].

Blanco, R ;

GonzalezGay, MA ;

Ibanez, D ;

SanchezAndrade, A ;

GonzalezVela, C .

NEPHRON, 1997, 76 (02) :247-248

[4]

CREAM J J, 1970, QJM, V39, P461

[5]

DWYER JM, 1992, NEW ENGL J MED, V326, P107

[6]

FILLASTRE JP, 1971, LANCET, V1, P1243

[7]

FOGAZZI GB, 1989, CLIN NEPHROL, V31, P60

[8] LONG-TERM FOLLOW-UP OF CHILDHOOD HENOCH-SCHONLEIN NEPHRITIS [J].

GOLDSTEIN, AR ;

WHITE, RHR ;

AKUSE, R ;

CHANTLER, C .

LANCET, 1992, 339 (8788) :280-282

[9] Intravenous immunoglobulin in Henoch-Schonlein purpura [J].

Hamidou, MA ;

Pottier, MA ;

Dupas, B .

ANNALS OF INTERNAL MEDICINE, 1996, 125 (12) :1013-1014

[10]

Heldrich F J, 1993, Md Med J, V42, P577

← 1 2 →