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Successful prednisolone therapy in elderly patients with severe forms of
henoch-schönlein purpura nephritis
#MMPMID25922591
Kato-Okada S
; Suzuki H
; Inoue T
; Kikuta T
; Okada H
Jpn Clin Med
2015[]; 6
(?): 5-7
PMID25922591
show ga
INTRODUCTION: Recently, Henoch-Schönlein purpura (HSP) has been observed in
elderly people, although it was believed to be uncommon in these subjects. The
increased risks of developing end-stage renal disease (ESRD) in adults in
comparison with children were highlighted by different studies; however, limited
data are available on the treatment of HSP nephritis in adults. METHODS: Between
2002 and 2008, five elderly Japanese patients (>65 years old) (mean age, 68
years, ranging from 65 to 72) with severe forms of HSP nephritis were entered
into a prospective study to evaluate prednisolone therapy on the outcome of
nephropathy in terms of clinical symptoms and histopathological changes. The
patients were considered at risk of developing chronic renal failure when they
presented with a nephrotic syndrome and crescentic glomeruli. RESULTS: At the
last follow-up, 4-10 years after initiation of the therapy, four patients had
clinically recovered and one died of lung cancer. No patients developed ESRD. The
clinical outcome seemed to be correlated with glomerular activity (massive
proteinuria and crescent formation). In spite of a relatively large dose of
prednisolone, a few adverse effects, such as insomnia and skin lesions, were
observed. DISCUSSION: Our preliminary small study suggests that renal outcome as
well as survival of elderly patients with severe forms of HSP might be altered by
aggressive prednisolone therapy.
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