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Managing Henoch–Schonlein purpura in children with fish oil and ACE inhibitor therapy
Author(s) -
DIXIT MEHUL P,
DIXIT NAZNIN M,
SCOTT KATHERINE
Publication year - 2004
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/j.1440-1797.2004.00320.x
Subject(s) - medicine , henoch schonlein purpura , fish oil , proteinuria , gastroenterology , renal function , nephropathy , purpura (gastropod) , blood pressure , renal biopsy , kidney , endocrinology , fish <actinopterygii> , vasculitis , disease , ecology , diabetes mellitus , fishery , biology
SUMMARY: Background: Henoch–Schonlein purpura (HSP) is a vasculitic syndrome with palpable purpura and renal involvement. The treatment for HSP with persistent renal disease remains controversial. The kidney biopsy in HSP shows IgA deposits and fish‐oil therapy has proven to be promising in halting the progression of IgA nephropathy. Methods: Five children with biopsy‐proven HSP with repeated episodes of haematuria and proteinuria were treated with fish oil (1 g orally twice daily). In three of the five patients an angiotensin‐converting enzyme inhibitor (ACEI) was added for hypertension. Results: The mean duration of follow up after starting fish‐oil therapy was 49.2 weeks. The protein excretion rate prior to starting fish oil was 1041 mg/day and on the last follow‐up visit the rate had decreased to 104 mg/day ( P < 0.05). The average blood pressure (BP) prior to therapy was 135/82. On the last follow‐up visit the average BP off ACEI had decreased to 100/54 ( P < 0.05). After a year of follow up serum creatinine and glomerular filtration rates have remained stable at 51.2 µmol/L and 128 mL/min/1.73 m 2 , respectively. Conclusion: This is the first report of abatement of HSP with fish oil and ACEI in children. There is a need for randomized prospective trials to confirm this observation.