A 8 year old male had non blanching rashes over the shin and swelling of knee joint with hematuria +++ and protein +. Microscopic analysis of his renal biopsy specimen is most likely to show. (AI 04)
|B||Visceral podocyte fusion|
|C||Mesangial deposits of IgA|
|D||Basement membrane thickening|
HenochSchönleinpurpura(Ref: H-18th edition, Pg-2797)
i. It is generalized vasculitis causing GN, purpura, arthralgias and abdominal pain, occurring mainly in children.
ii. Small Vasculitis, palpable purpura(AIPG 07)
iii. Skin biopsy specimen can be useful in confirming leukocytoclasticvasculitis with IgA and C3 deposition by immunofluorescence.
iv. Tetrad – 1. Palpable purpura 2. Arthritis (Migratory) 3. Glomerulo nephritis 4. Abdominal pain.
v. Renal involvement is manifested by hematuria and proteinuria.
vi. Serum IgA is normal, platelet count is normal. (FAQ)
vii. Platelet count is normal.
viii. Serum compliment levels are normal.
ix. Treatment is symptomatic.
xi. Glucocorticoid is used in its treatment.
xi. The prognosis of HSP is excellent.
1. Recurrent episodes of painless gross hematuria represent the classic clinical presentation of IgA nephropathy,
2. The most common systemic vasculitis in children is HSP, and the most common primary glomerular disease is IgA Nephropathy. H.S purpura and IgA nephropathy may actually represent spectra of same disease and both are associated with elevated levels of IgA.
3. ANA and ANCA are characteristically Negative and serum complement levels are typically normal.