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Henoch-Schönlein Nephritis Follow-up in Children

Long-term renal monitoring of children with IgA vasculitis nephritis to detect chronic kidney disease.

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Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Çocuk Sağlığı ve Hastalıkları department. Book Appointment →

What is Henoch-Schönlein Nephritis Follow-up in Children?

Henoch-Schönlein purpura (IgA vasculitis) is the most common childhood vasculitis, presenting with palpable purpura, arthralgia, abdominal pain, and renal involvement (HSN). Nephritis develops in 20 to 60 percent of children, ranging from isolated microhematuria to nephrotic-nephritic syndrome and crescentic glomerulonephritis. Most cases resolve spontaneously, but a subset progresses to chronic kidney disease and end-stage kidney failure decades later.

Risk factors for chronic kidney disease include nephrotic-range proteinuria at presentation, decreased estimated GFR, hypertension, persistent proteinuria beyond 6 months, and crescents on biopsy. Renal biopsy with ISKDC or Oxford classification is performed in nephrotic-range proteinuria, persistent significant proteinuria, or impaired GFR.

Surveillance protocol: weekly urinalysis and blood pressure for the first month, every 2 weeks for 1 to 3 months, monthly to 6 months, and every 3 to 6 months until 12 to 24 months of disease-free follow-up. Children with persistent proteinuria require ACE inhibitor or ARB and may need corticosteroids, mycophenolate, or cyclophosphamide for severe nephritis. Annual review until adulthood is recommended for any past HSN.

Symptoms

Palpable purpura on lower extremities
Arthralgia and joint swelling
Crampy abdominal pain and GI bleeding
Microscopic or gross hematuria
Proteinuria with possible nephrotic edema
Hypertension during active disease
Recurrent flares within first year

Risk Factors

Age 4-7 years and male sex
Recent upper respiratory tract infection
Streptococcal exposure
Family history of IgA nephropathy
HLA susceptibility alleles
Recurrent purpura episodes
Initial nephrotic-range proteinuria

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • New purpura with abdominal or joint pain
  • Hematuria persisting beyond 6 months
  • Nephrotic-range proteinuria at presentation
  • Hypertension in HSN follow-up
  • Rising creatinine in known HSN

Treatment Methods

01
Urinalysis and blood pressure surveillance schedule
02
ACE inhibitor or ARB for persistent proteinuria
03
Renal biopsy for severe or persistent disease
04
Corticosteroids for nephrotic syndrome
05
Mycophenolate or cyclophosphamide in crescentic GN
06
Salt restriction and weight monitoring
07
Annual nephrology review until adulthood

Which Department to Visit?

You can visit our Çocuk Sağlığı ve Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.