[Comparative analysis of clinicopathological findings and outcome of Henoch-Schonlein nephritis and IgA nephropathy in adults].

Objective: To compare the clinicopathological findings and prognosis of Henoch-Schonlein nephritis (HSPN) and IgA nephropathy (IgAN) in adults.

Methods: We enrolled 31 patients with HSPN and 62 patients with IgAN in the present study. They were followed up for 47+/-23 months and 47+/-20 months respectively, and their clinical manifestations and renal pathological findings were collected. Renal pathological changes were semiquantitatively graded.

Results: The clinical manifestations, including hypertension, excretion of serum creatinine and urinary protein, were similar in patients with HSPN and IgAN [38.7% vs 27.4%, (121+/-164) vs (106+/-43) micromol/L, (3.2+/-3.1) vs (2.8+/-2.9) g/d, P>0.05]. Renal pathological investigation showed endothelial proliferation in 40.6% (13/31) of HSPN patients and 19.4% (12/62) of IgAN patients and the difference was significant (P=0.021). In patients with IgAN, the tubulointerstitial chronicity index was higher than that in HSPN (2 vs 1, P=0.009), but there were no statistically significant differences in crescent formation(including segmental glomerular necrosis) and glomerular sclerosis(1 vs 0, 1 vs 1, P>0.05). In patients with HSPN capillary wall staining for IgA was more frequently found than in IgAN (71.0% vs 43.5%, P=0.013). With creatinine level doubling as the end point, the follow-up data indicated that the renal survival was 87.1% in HSPN and 91.9% in IgAN and there was no statistically significant difference between HSPN and IgAN (P=0.481).

Conclusion: Although significant pathological difference was found between HSPN and IgAN, the renal clinical manifestations and long term outcome were similar between the two diseases in adults.