Henoch – SchönleinPurpura (HSP)
i. It is generalized vasculitis causing GN, purpura, arthralgias and abdominal pain, occurring mainly in children.
ii. Renal involvement is manifested by hematuria and proteinuria.
iii. Serum IgA is normal, platelet count is normal. (FAQ)
iv. Treatment is symptomatic.
Laboratory Feature of Renal vasculitis in children due to HSP
i. Serum IgA levels Normal or Elevated (60% of patients have an elevated serum IgA)
ii. Antinuclear antibody (ANA) Negative
iii. ANCA Negative
v. Complement (C3, C4) Normal
Even though immune complexes containing IgA are essential to the pathophysiology of HSP, serum complement levels are usually normal.
vi. Cryoglobulins Negative
1. Recurrent episodes of painless gross hematuria represent the classic clinical presentation of IgA nephropathy,
2. The most common systemic vasculitis in children is HenochSchönleinPurpura, 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 normal or elevated levels of IgA.
3. ANA and ANCA are characteristically Negative and serum complement levels are typically normal.
Characteristic Causes of Recurrent Gross Hematuria (Nelson 18th edition, Pg/2169)
1. IgA Nephropathy
2. Alport’ssyndrome - Isolated Glomerular diseases with recurrent Gross hematuria
3. Thin Glomerular basement membrane disease
TABLE 264-8 Drug-Induced Glomerular Disease
Morphologic Lesion Causative Agent
1. Minimal change diseases (usually Nonsteroidal anti-inflammatory agents,
with interstitial nephritis) Recombinant interferon , Rifampin, Ampicillin
2. Membranous nephropathy Penicillamine, Gold, Mercury, Trimethadione, Captopril,
3. Focal segmental glomerulosclerosis Heroin
4. Pauci-immune necrotizing GN Ciprofloxacin
5. Proliferative GN with vasculitis Allopurinol, Penicillin, Sulfonamides, Thiazides,
6. RPGN Rifampin, Warfarin, Carbimazole, Amoxicillin, Penicillamine