PMID: 16509462Mar 3, 2006Paper

Streptococcal origin of a case of Henoch-Schoenlein purpura nephritis

Clinical Nephrology
Y KikuchiSoichiro Miura

Abstract

We report the case of a 25-year-old man with abdominal pain, purpura on the legs and proteinuria occurring 2 weeks after acute tonsillitis, and admitted to our hospital with suspected Henoch-Schönlein purpura nephritis (HSPN). He had increased anti-streptolysin O (ASO) titer and hypocomplementemia. A renal biopsy specimen showed endocapillary proliferative changes, which are typical of acute poststreptococcal glomerulonephritis (APSGN). However, immunofluorescence study revealed predominant IgA and C3 deposits in mesangial lesions, indicating a diagnosis of HSPN. Because of massive proteinuria initially, the treatment with a combination of prednisolone, cyclophosphamide, dipyridamole and warfarin was started along with 3 plasma exchanges. Angiotensin-converting enzyme inhibitor was also given. Response to the treatment was favorable. A follow-up biopsy was performed 8 months after the first biopsy. The renal biopsy specimen showed a figure of typical HSPN. To further investigate the cause of glomerular changes in our patient, an immunofluorescent study of nephritogenic nephritis-associated plasmin receptor (NAPlr) of group A, beta-hemolytic streptococci was performed. NAPlr was significantly positive in the glomeruli in the fir...Continue Reading

Citations

Feb 3, 2009·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Ninoska VieraJesus Mosquera
Sep 10, 2010·Clinical and Experimental Nephrology·Yoshitaka IwazuEiji Kusano
Sep 20, 2008·European Journal of Pediatrics·Toru Watanabe, Yumi Baba
Jun 21, 2011·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Takahiro UchidaHiroo Kumagai
Jan 9, 2010·The American Journal of Pathology·Roland SchmittDiana Karpman
Jan 23, 2021·International Journal of Molecular Sciences·Takashi Oda, Nobuyuki Yoshizawa

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