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Presentation of pediatric Henoch-Schönlein purpura nephritis changes with age and renal histology depends on biopsy timing

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Presentation of pediatric Henoch-Schönlein purpura nephritis changes with age and renal histology depends on biopsy timing. / Hennies, Imke; Gimpel, Charlotte; Gellermann, Jutta; Möller, Kristina; Mayer, Brigitte; Dittrich, Katalin; Büscher, Anja K; Hansen, Matthias; Aulbert, Wiebke; Wühl, Elke; Nissel, Richard; Schalk, Gessa; Weber, Lutz T; Pohl, Michael; Wygoda, Simone; Beetz, Rolf; Klaus, Günter; Fehrenbach, Henry; König, Sabine; Staude, Hagen; Beringer, Ortraud; Bald, Martin; Walden, Ulrike; von Schnakenburg, Christian; Bertram, Gunhard; Wallot, Michael; Häffner, Karsten; Wiech, Thorsten; Hoyer, Peter F; Pohl, Martin; German Society of Pediatric Nephrology.

In: PEDIATR NEPHROL, Vol. 33, No. 2, 02.2018, p. 277-286.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Hennies, I, Gimpel, C, Gellermann, J, Möller, K, Mayer, B, Dittrich, K, Büscher, AK, Hansen, M, Aulbert, W, Wühl, E, Nissel, R, Schalk, G, Weber, LT, Pohl, M, Wygoda, S, Beetz, R, Klaus, G, Fehrenbach, H, König, S, Staude, H, Beringer, O, Bald, M, Walden, U, von Schnakenburg, C, Bertram, G, Wallot, M, Häffner, K, Wiech, T, Hoyer, PF, Pohl, M & German Society of Pediatric Nephrology 2018, 'Presentation of pediatric Henoch-Schönlein purpura nephritis changes with age and renal histology depends on biopsy timing', PEDIATR NEPHROL, vol. 33, no. 2, pp. 277-286. https://doi.org/10.1007/s00467-017-3794-1

APA

Hennies, I., Gimpel, C., Gellermann, J., Möller, K., Mayer, B., Dittrich, K., Büscher, A. K., Hansen, M., Aulbert, W., Wühl, E., Nissel, R., Schalk, G., Weber, L. T., Pohl, M., Wygoda, S., Beetz, R., Klaus, G., Fehrenbach, H., König, S., ... German Society of Pediatric Nephrology (2018). Presentation of pediatric Henoch-Schönlein purpura nephritis changes with age and renal histology depends on biopsy timing. PEDIATR NEPHROL, 33(2), 277-286. https://doi.org/10.1007/s00467-017-3794-1

Vancouver

Hennies I, Gimpel C, Gellermann J, Möller K, Mayer B, Dittrich K et al. Presentation of pediatric Henoch-Schönlein purpura nephritis changes with age and renal histology depends on biopsy timing. PEDIATR NEPHROL. 2018 Feb;33(2):277-286. https://doi.org/10.1007/s00467-017-3794-1

Bibtex

@article{f9c6b110a18a47c490e29bb28cab841a,
title = "Presentation of pediatric Henoch-Sch{\"o}nlein purpura nephritis changes with age and renal histology depends on biopsy timing",
abstract = "BACKGROUND: This study correlates the clinical presentation of Henoch-Sch{\"o}nlein purpura nephritis (HSPN) with findings on initial renal biopsy.METHODS: Data from 202 pediatric patients enrolled in the HSPN registry of the German Society of Pediatric Nephrology reported by 26 centers between 2008 and 2014 were analyzed. All biopsy reports were re-evaluated for the presence of cellular crescents or chronic pathological lesions (fibrous crescents, glomerular sclerosis, tubular atrophy >5%, and interstitial fibrosis >5%).RESULTS: Patients with HSPN with cellular glomerular crescents were biopsied earlier after onset of nephritis (median 24 vs 36 days, p = 0.04) than those without, whereas patients with chronic lesions were biopsied later (57 vs 19 days, p < 0.001) and were older (10.3 vs 8.6 years, p = 0.01) than those without. Patients biopsied more than 30 days after the onset of HSPN had significantly more chronic lesions (52 vs 22%, p < 0.001), lower eGFR (88 vs 102 ml/min/1.73m2, p = 0.01), but lower proteinuria (2.3 vs 4.5 g/g, p < 0.0001) than patients biopsied earlier. Children above 10 years of age had lower proteinuria (1.98 vs 4.58 g/g, p < 0.001), lower eGFR (86 vs 101 ml/min/1.73m2, p = 0.002) and were biopsied significantly later after onset of nephritis (44 vs 22 days, p < 0.001) showing more chronic lesions (45 vs 30%, p = 0.03). Proteinuria and renal function at presentation decreased with age.CONCLUSIONS: In summary, we find an age-dependent presentation of HSPN with a more insidious onset of non-nephrotic proteinuria, impaired renal function, longer delay to biopsy, and more chronic histopathological lesions in children above the age of 10 years. Thus, HSPN presents more like Immunoglobulin A (IgA) nephritis in older than in younger children.",
keywords = "Journal Article",
author = "Imke Hennies and Charlotte Gimpel and Jutta Gellermann and Kristina M{\"o}ller and Brigitte Mayer and Katalin Dittrich and B{\"u}scher, {Anja K} and Matthias Hansen and Wiebke Aulbert and Elke W{\"u}hl and Richard Nissel and Gessa Schalk and Weber, {Lutz T} and Michael Pohl and Simone Wygoda and Rolf Beetz and G{\"u}nter Klaus and Henry Fehrenbach and Sabine K{\"o}nig and Hagen Staude and Ortraud Beringer and Martin Bald and Ulrike Walden and {von Schnakenburg}, Christian and Gunhard Bertram and Michael Wallot and Karsten H{\"a}ffner and Thorsten Wiech and Hoyer, {Peter F} and Martin Pohl and {German Society of Pediatric Nephrology}",
year = "2018",
month = feb,
doi = "10.1007/s00467-017-3794-1",
language = "English",
volume = "33",
pages = "277--286",
journal = "PEDIATR NEPHROL",
issn = "0931-041X",
publisher = "Springer",
number = "2",

}

RIS

TY - JOUR

T1 - Presentation of pediatric Henoch-Schönlein purpura nephritis changes with age and renal histology depends on biopsy timing

AU - Hennies, Imke

AU - Gimpel, Charlotte

AU - Gellermann, Jutta

AU - Möller, Kristina

AU - Mayer, Brigitte

AU - Dittrich, Katalin

AU - Büscher, Anja K

AU - Hansen, Matthias

AU - Aulbert, Wiebke

AU - Wühl, Elke

AU - Nissel, Richard

AU - Schalk, Gessa

AU - Weber, Lutz T

AU - Pohl, Michael

AU - Wygoda, Simone

AU - Beetz, Rolf

AU - Klaus, Günter

AU - Fehrenbach, Henry

AU - König, Sabine

AU - Staude, Hagen

AU - Beringer, Ortraud

AU - Bald, Martin

AU - Walden, Ulrike

AU - von Schnakenburg, Christian

AU - Bertram, Gunhard

AU - Wallot, Michael

AU - Häffner, Karsten

AU - Wiech, Thorsten

AU - Hoyer, Peter F

AU - Pohl, Martin

AU - German Society of Pediatric Nephrology

PY - 2018/2

Y1 - 2018/2

N2 - BACKGROUND: This study correlates the clinical presentation of Henoch-Schönlein purpura nephritis (HSPN) with findings on initial renal biopsy.METHODS: Data from 202 pediatric patients enrolled in the HSPN registry of the German Society of Pediatric Nephrology reported by 26 centers between 2008 and 2014 were analyzed. All biopsy reports were re-evaluated for the presence of cellular crescents or chronic pathological lesions (fibrous crescents, glomerular sclerosis, tubular atrophy >5%, and interstitial fibrosis >5%).RESULTS: Patients with HSPN with cellular glomerular crescents were biopsied earlier after onset of nephritis (median 24 vs 36 days, p = 0.04) than those without, whereas patients with chronic lesions were biopsied later (57 vs 19 days, p < 0.001) and were older (10.3 vs 8.6 years, p = 0.01) than those without. Patients biopsied more than 30 days after the onset of HSPN had significantly more chronic lesions (52 vs 22%, p < 0.001), lower eGFR (88 vs 102 ml/min/1.73m2, p = 0.01), but lower proteinuria (2.3 vs 4.5 g/g, p < 0.0001) than patients biopsied earlier. Children above 10 years of age had lower proteinuria (1.98 vs 4.58 g/g, p < 0.001), lower eGFR (86 vs 101 ml/min/1.73m2, p = 0.002) and were biopsied significantly later after onset of nephritis (44 vs 22 days, p < 0.001) showing more chronic lesions (45 vs 30%, p = 0.03). Proteinuria and renal function at presentation decreased with age.CONCLUSIONS: In summary, we find an age-dependent presentation of HSPN with a more insidious onset of non-nephrotic proteinuria, impaired renal function, longer delay to biopsy, and more chronic histopathological lesions in children above the age of 10 years. Thus, HSPN presents more like Immunoglobulin A (IgA) nephritis in older than in younger children.

AB - BACKGROUND: This study correlates the clinical presentation of Henoch-Schönlein purpura nephritis (HSPN) with findings on initial renal biopsy.METHODS: Data from 202 pediatric patients enrolled in the HSPN registry of the German Society of Pediatric Nephrology reported by 26 centers between 2008 and 2014 were analyzed. All biopsy reports were re-evaluated for the presence of cellular crescents or chronic pathological lesions (fibrous crescents, glomerular sclerosis, tubular atrophy >5%, and interstitial fibrosis >5%).RESULTS: Patients with HSPN with cellular glomerular crescents were biopsied earlier after onset of nephritis (median 24 vs 36 days, p = 0.04) than those without, whereas patients with chronic lesions were biopsied later (57 vs 19 days, p < 0.001) and were older (10.3 vs 8.6 years, p = 0.01) than those without. Patients biopsied more than 30 days after the onset of HSPN had significantly more chronic lesions (52 vs 22%, p < 0.001), lower eGFR (88 vs 102 ml/min/1.73m2, p = 0.01), but lower proteinuria (2.3 vs 4.5 g/g, p < 0.0001) than patients biopsied earlier. Children above 10 years of age had lower proteinuria (1.98 vs 4.58 g/g, p < 0.001), lower eGFR (86 vs 101 ml/min/1.73m2, p = 0.002) and were biopsied significantly later after onset of nephritis (44 vs 22 days, p < 0.001) showing more chronic lesions (45 vs 30%, p = 0.03). Proteinuria and renal function at presentation decreased with age.CONCLUSIONS: In summary, we find an age-dependent presentation of HSPN with a more insidious onset of non-nephrotic proteinuria, impaired renal function, longer delay to biopsy, and more chronic histopathological lesions in children above the age of 10 years. Thus, HSPN presents more like Immunoglobulin A (IgA) nephritis in older than in younger children.

KW - Journal Article

U2 - 10.1007/s00467-017-3794-1

DO - 10.1007/s00467-017-3794-1

M3 - SCORING: Journal article

C2 - 28983704

VL - 33

SP - 277

EP - 286

JO - PEDIATR NEPHROL

JF - PEDIATR NEPHROL

SN - 0931-041X

IS - 2

ER -