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Effectiveness of early prednisone treatment in preventing the development of nephropathy in anaphylactoid purpura

  • Nephrology/Urology
  • Published:
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Abstract

A prospective study was performed to verify whether early administration of prednisone could be useful in preventing the development of nephropathy in anaphylactoid purpura. Only patients without signs of nephropathy upon initial presentation entered into the study. A total of 84 patients received delta-prednisone (1 mg/kg per day per os for 2 weeks), and 84 patients did not receive steroids. The patients were followed for 24–36 months. None of the 84 patients treated with steroids and 10 (11.9%) of the 84 control patients developed nephropathy 2–6 weeks after the acute episode. In 2 other patients of the untreated group, signs of renal involvement appeared 2 and 6 years after the acute episode respectively. The difference in the prevalence of nephropathy between the two groups is highly significant (P<0.001).

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Abbreviations

AP:

anaphylactoid purpura

References

  1. Anonymous (1977) Henoch-Schönlein purpura. BMJ I:190–191

  2. Baart de la Faille-Kuyper EH, Kater L, Kooiker CJ, Dorhout Mees EJ (1973) IgA deposits in cutaneous blood-vessel walls and mesangium in Henoch-Schönlein syndrome. Lancet I: 892–893

    Article  Google Scholar 

  3. Beale DG, Nash GS, Bertovich MJ, McDermott RP (1982) Similar disturbances in B cell activity and regulatory T cell function in Henoch-Schönlein and systemic lupus erythematosus. J Immunol 128:486–491

    PubMed  Google Scholar 

  4. Bertotto A, De Felicis Arcangeli C, Gerli R, Spinozzi F, Fabietti G, Germini G, Crupi S, Vaccaro R (1985) Eterogeneità fenotipica della popolazione T4+ in bambini con peliosi reumatica. Riv Ital Pediatr (IJP) 11:753–754

    Google Scholar 

  5. Buchanec J, Galanda V, Belãkova S, Minarik M, Zibolen M (1988) Incidence of renal complications in Schönlein-Henoch purpura syndrome in dependence of an early administration of steroids. Int J Nephrol 20:409–412

    Google Scholar 

  6. Cameron JS (1975) Glomerulonephritis in children. Pediatrician 4:16–26

    Google Scholar 

  7. Coppo R, Basolo B, Martina G, Rollino C, De Marchi M, Giocchino F, Mazzucco G, Messina M, Piccoli G (1982) Circulating immunocomplexes containing IgA, IgG and IgM in patients with primary IgA nephropathy and with Henoch-Schönlein nephritis. Correlation with clinical and histological signs of activity. Clin Nephrol 18:230–239

    PubMed  Google Scholar 

  8. Giangiacomo J, Tsai CC (1977) Dermal and glomerular deposition of IgA in anaphylactoid purpura. Am J Dis Child 131:981–983

    PubMed  Google Scholar 

  9. Goodwin JS, Atiuru D, Sierakowski S, Lianas EA (1986) Mechanism of action of glucocorticosteroids. Inhibition of T cell proliferation and interleukin 2 production by hydrocortisone is reversed by leukotriene B4. J Clin Invest 77:1244–1250

    PubMed  Google Scholar 

  10. Hall RP, Lawley TS, Heck JA, Katz SI (1980) IgA containing circulating immunocomplexes in dermatitis herpetiformis, Henoch-Schönlein purpura, systemic lupus erythematosus and other diseases. Clin Exp Immunol 40:431–437

    PubMed  Google Scholar 

  11. Kauffmann RH, Hermann WA, Meyer CJLM, Dehia MR, Von Es LA (1980) Circulating IgA immunocomplexes in Henoch-Schönlein purpura. A longitudinal study of their relationship to disease activity and vascular deposition of IgA. Am J Med 69:859–866

    PubMed  Google Scholar 

  12. Koskimies O, Sevgi M, Rapola J, Vilska J (1981) Henoch-Schönlein nephritis: long-term prognosis of unselected patients. Arch Dis Child 56:482–484

    PubMed  Google Scholar 

  13. Kuno-Sakai H, Sakai H, Nomoto Y, Takakura I, Kimura M (1979) Increase of IgA bearing peripheral blood lymphocytes in children with Henoch-Schönlein purpura. Pediatrics 64: 918–922

    PubMed  Google Scholar 

  14. Levinsky RJ, Barratt TM (1979) IgA immune complexes in Henoch-Schönlein purpura. Lancet II:1100–1103

    Article  Google Scholar 

  15. Li Volti S, Minniti CP, Gangemi B, Mollica F (1985) Studio immunologico di bambini con porpora di Schönlein-Henoch. Riv Ital Pediatr (IJP) 11:215–216

    Google Scholar 

  16. Mantovani G, Orgiana G, Degioannis G, Corrias A, Corda R (1984) Studio immunologico di otto pazienti in età infantile con porpora di Schönlein-Henoch. Riv Ital Pediatr (IJP) 10: 146–149

    Google Scholar 

  17. Meadow SR (1978) Schönlein-Henoch syndrome. In: Edelmann C M Jr (ed) Diseases of the kidney. Little Brown & Co, Boston, pp 788–796

    Google Scholar 

  18. Mollica F, Li Volti S, Musumeci S, Sciotto A, Garozzo R, Russo G (1980) Immunological function in childhood anaphylactoid purpura and an attempt to the prevention of nephropathy by corticosteroids. In: Ballabriga A, Gallart A (eds) Proceedings XVI Int Congr Pediatr. Barcelona, Abstracts of Symposia & Colloquia, pp 450

  19. Musumeci S, Sciotto A, Rosalba A, Li Volti S, Mollica F (1980) Lymphocyte subpopulations in anaphylactoid purpura. Arch Dis Child 55:541–543

    PubMed  Google Scholar 

  20. Peratoner L, Longo F, Lepore L, Freschi P (1990) Prophylaxis and therapy of glomerulonephritis in the course of anaphylactoid purpura. The results of a polycentric clinical trial. Acta Paediatr Scand 79:976–977

    PubMed  Google Scholar 

  21. Petterson E, Von Willebrand E, Honkoneu E (1985) Immunological mechanism in glomerulonephritis. Scand J Urol Nephrol 19 [Suppl 90]:29–34

    Google Scholar 

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Mollica, F., LiVolti, S., Garozzo, R. et al. Effectiveness of early prednisone treatment in preventing the development of nephropathy in anaphylactoid purpura. Eur J Pediatr 151, 140–144 (1992). https://doi.org/10.1007/BF01958961

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  • DOI: https://doi.org/10.1007/BF01958961

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