Tohoku J. Exp. Med., 2007, 211(3)

Case Report

Efficacy of Tonsillectomy Plus Methylprednisolone Pulse Therapy for a Child with Henoch-Schoenlein Purpura Nephritis

YUKIHIKO KAWASAKI,¹ KAZUHIDE SUYAMA,¹ AYUMI MATSUMOTO,¹ KEI TAKANO,¹ KOICHI HASHIMOTO,¹ SIGEO SUZUKI,¹ JUNZO SUZUKI,¹ HITOSHI SUZUKI¹ and MITSUAKI HOSOYA¹

¹Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, Japan

Henoch-Schoenlein purpura (HSP) is a systemic disorder characterized by a leukocytoplastic vasculitis involving small vessels with the deposition of immunoglobulin A (IgA) immune complexes. Renal involvement is the principal cause of morbidity and mortality in children with HSP. We report here an 11-year-old boy with Henoch-Schoenlein purpura nephritis (HSPN) accompanied by recurrent purpura and persistent nephropathy despite conventional therapy such as prednisolone, methylprednisolone pulse therapy and immunosuppressive agent (Mizoribine). The patient was treated with tonsillectomy plus methylprednisolone pulse therapy. This treatment decreased proteinuria, induced disappearance of microscopic hematuria, and improved renal pathological findings. Tonsillectomy plus methylprednisolone pulse is effective and useful therapy for some children with recurrent purpura and persistent nephropathy.

keywords —— HSPN; methylprednisolone pulse; urokinase pulse; tonsillectomy; recurrent purpura

© 2007 Tohoku University Medical Press

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Tohoku J. Exp. Med., 2007, 211, 291-295

Correspondence: Dr. Yukihiko Kawasaki, Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima 960-1295, Japan.

e-mail: tomo@fmu.ac.jp