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Local leukocyte proliferation as a target for cyclophosphamide in the treatment of H enoch‐ S chönlein purpura nephritis grade VI
Author(s) -
Kaneko Masahiro,
Ikezumi Yohei,
Yamada Takeshi,
Hasegawa Hiroya,
Kaneko Utako,
Saitoh Akihiko
Publication year - 2016
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/nep.12558
Subject(s) - medicine , cyclophosphamide , nephritis , proteinuria , purpura (gastropod) , immunology , glomerulonephritis , nephrotic syndrome , pathogenesis , gastroenterology , kidney , chemotherapy , biology , ecology
Abstract Henoch‐Schönlein purpura nephritis ( HSPN ) is one of the most common types of chronic glomerulonephritis in children; however, there have been few reports on the pathogenesis and management of grade VI HSPN . We present the case of a 6‐year‐old boy with grade VI HSPN accompanied by severe nephrotic syndrome and hypocomplementaemia. Immunohistological studies revealed profound glomerular accumulation of CD 45‐ and CD 68‐positive inflammatory cells. Moreover, some cells expressed the proliferating marker proliferating cell nuclear antigen. His proteinuria and general oedema persisted despite repeated high‐dose steroid therapy; however, these clinical symptoms immediately improved after beginning treatment with cyclophosphamide ( CyP ). Grade VI HSPN was successfully treated with steroids and immunosuppressants. Among immunosuppressive drugs, CyP was considered the most effective.