Advertising Disclaimer
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow View eLetters
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Web of Science (13)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Kawasaki, Y.
Right arrow Articles by Suzuki, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Kawasaki, Y.
Right arrow Articles by Suzuki, H.
Related Collections
Right arrow Genitourinary Tract
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

PEDIATRICS Vol. 111 No. 4 April 2003, pp. 785-789

Efficacy of Methylprednisolone and Urokinase Pulse Therapy for Severe Henoch-Schönlein Nephritis

Yukihiko Kawasaki, MD, Junzo Suzuki, MD, Ruriko Nozawa, MD, Shigeo Suzuki, MD, Hitoshi Suzuki, MD

From the Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan

--> Objective. To evaluate the efficacy of methylprednisolone and urokinase pulse therapy (MUPT) for severe Henoch-Schönlein nephritis, we examined the clinical manifestation and prognosis of patients with MUPT on long-term observation.

Methods. We enrolled 56 patients with Henoch-schönlein nephritis who had been diagnosed with at least type IIIb from 1980 to 1998 on long-term observation and had been treated with MUPT. The clinical features, laboratory data, and pathologic findings between "pre-MUPT" and "post-MUPT," and the prognosis of these patients on long-term observation were retrospectively investigated.

Results. The mean urinary protein excretion after 6 months of treatment had decreased significantly compared with "pre-MUPT." Hypercoagulant state in "after the completion of urokinase pulse therapy" improved compared with "pre-MUPT." First renal biopsies were performed in all patients and second biopsies were performed in 27 patients. The activity index decreased significantly from 4.1 ± 1.9 at first biopsy to 2.5 ± 1.7 at second biopsy, while the chronicity index did not differ between first and second biopsy. None had renal insufficiency and renal survival rate was 100% for the decade.

Conclusions. Although uncontrolled, our study suggested that MUPT is effective for those patients with the risk of progression of their nephropathy, especially if started early during the course of the disease before the crescents become fibrous.

Key Words: Henoch-Schönlein nephritis • methylprednisolone • urokinase • prognosis

Abbreviations: HSP, Henoch-Schönlein purpura • MUPT, methylprednisolone and urokinase pulse therapy • HSPN, Henoch-Schönlein nephritis • Ig, immunoglobulin • UK, urokinase • MPT, methylprednisolone pulse therapy • {alpha}2PI, {alpha}2 plasmin inhibitor • 24hCcr, 24-hour creatinine clearance • LM, light microscopy • IF, immunofluorescence • TAT, thrombin antithrombin III complex

Received for publication Apr 2, 2002; Accepted Sep 5, 2002.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 J. Clin. Pathol.Home page
J I Shin, J M Park, Y H Shin, J S Lee, and H J Jeong
Role of mesangial fibrinogen deposition in the pathogenesis of crescentic Henoch-Schonlein nephritis in children
J. Clin. Pathol., November 1, 2005; 58(11): 1147 - 1151.
[Abstract] [Full Text] [PDF]

Home page
 Rheumatology (Oxford)Home page
Y.-H. Yang, C.-F. Hung, C.-R. Hsu, L.-C. Wang, Y.-H. Chuang, Y.-T. Lin, and B.-L. Chiang
A nationwide survey on epidemiological characteristics of childhood Henoch-Schonlein purpura in Taiwan
Rheumatology, May 1, 2005; 44(5): 618 - 622.
[Abstract] [Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
Y. Kawasaki, J. Suzuki, and H. Suzuki
Efficacy of methylprednisolone and urokinase pulse therapy combined with or without cyclophosphamide in severe Henoch-Schoenlein nephritis: a clinical and histopathological study
Nephrol. Dial. Transplant., April 1, 2004; 19(4): 858 - 864.
[Abstract] [Full Text] [PDF]

eLetters:

Read all eLetters

Mesangial fibrinogen deposition in childhood Henoch-Schonlein nephritis
Jae Seung Lee, et al.
Pediatrics Online, 8 Jan 2006 [Full text]