Adult onset henoch schonlein purpura with nepthritis in rapidly progressive glomerulonephritis a relapse towards end stage renal disease / Salvador Pedro G. Rebullida and Ramon Mora.

Includes appendices and bibliographical references.

ABSTRACT: Rapidly progressive glomerulonephritis (RPGN) is a disease of the kidney characterized clinically by a rapid decrease in the glomerular filtration rate (GFR) of at least 50% over a short period, from a few days to 3 months. The calculated annual incidence of crescentic GN/RPGN is 0.7/100,000 amongst these cases there was noted presence of underlying disorders such as Henoch-Schonlein Purpura. Renal function is HSP showed 11% of patient reached end-stage renal failure, 13% exhibited severe renal failure (CrC1<30 ml/min), and 14% moderate renal insufficiency (CrC1 <50 ml/min). An 89 year old female diagnosed with Henoch Schonlein Purpura was admitted for difficulty of breathing where UPCR was noted to be 10.8 and was managed as HSP relapse with mycophenolate mofetil, diuretics and was discharged improved. Two days later was admitted for abdominal pain and elevated blood pressure, later developed joint pains and purpura and with progressive elevation of creatinine on serial determination. Mycophenolate mofetil and methyprednisolone pulse therapy was given but despite therapy, renal function deteriorated and was eventually started on renal replacement therapy. There still is vast information unknown about HSP Nephritis, in its variable course of disease and treatment. The lack of RCT involving adults as compared to children has limited the treatment modalities. Institutions should be encouraged to document and contribute to the pool of information for the advancement in the treatment of HSP Nephritis.

Research - Department of Medicine