36 children with Henoch-Schönlein nephritis had their renal biopsy specimens studied by light and electron microscopic and immunofluorescence antibody techniques. Though no pathognomic changes were found the histological picture was characteristic. The severity of histological changes correlated well with the clinical manifestation and disease persistence. IMF studies showed characteristic mesangial IgA staining. The most prominent ultrastructural feature was segmental mesangial and subendothelial deposits with basement membrane changes. The amount of deposits was a good exponent of disease activity-children with few deposits recovering shortly. In spite of long duration, the outcome after an average 4 year follow-up was good, the majority of children having improved and renal insufficiency developing rarely. Renal biopsy is essential for an estimation of severity of renal disease and enables prognosis of disease persistence and long term outlook.
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