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Suggest Treatment For Henoch–Schönlein Purpura
Hi, my friend was diagnosed Henoch Schonlein Purpura around 3 months back, now his kidneys are being affected, renal biopsy done and report comes as, 10 glomeruli are present, the section are for IgG, IgM, IgA, c3, c1q, kappa & lambada light chains. IgA(+3) is positive over the magnesium. There is light chain restriction IgG, IgM, IgA, c3, c1q are negetive. LIGHT MICROSCOPY *Section are special stains ( PAS, silver and trichrome) include renal cortex and medulla. *Upto 12 glomeruli are seen in this biopsy, of which one glomerulus is globally sclerotic. * The remaining glomeruli show an increase in mesangial cellularity and mesangial matrix. * Segmental endocapillary proliferation is observed in 6 glomeruli and early cellular cresent in 5 glomeruli. * No spikes or double contours are seen on the glomerular basement membranes. * Tubules are dilated and the lining epithelium cells are thinned out. * No vascular pathology seen. DIAGNOSIS: Features are consistent with IgA vasculitis ( Henoch Schonlein Purpura) Nephretis. Now he is taking Celcept, Wysolone... but in his KFT S. creatine level never goes down 1.6mg/dl and urine protein 2+ I just wanted to know is, Can his kidney be protected from permanent damage by medication .. wat should we do further... please help.
Fri, 28 Oct 2022
Hello,
Treatment of Henoch-Schonlein purpura remains primarily supportive in most cases, though pharmacotherapy, plasmapheresis, and surgical interventions may also be considered in select cases. Supportive measures may include ensuring adequate hydration, monitoring for GI and kidney complications, treating minor symptoms of arthritis, edema, fever, or malaise, eating a bland diet, and discontinuing any drugs suspected of playing a causative role
Joint and soft tissue discomfort may be reduced by giving analgesics, such as Acetaminophen, Ibuprofen, Flurbiprofen, Ketoprofen, and Naproxen. Corticosteroids may be considered in situations like persistent nephrotic syndrome, crescents in more than 50% of glomeruli, severe abdominal pain, and substantial GI hemorrhage.
Treatment regimens have included IV or oral steroids with or without Azathioprine, Cyclophosphamide, Cyclosporine, Angiotensin converting enzyme inhibitors or angiotensin receptor blockers, Dipyridamole, high-dose IV immunoglobulin G (IVIg), Danazol, and fish oil. Plasmapheresis could be effective to delay the progression of kidney disease. His kidney damage can be prevented from progressing further with above drugs including steroids.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. Pallavi M., Anesthesiologist
Treatment of Henoch-Schonlein purpura remains primarily supportive in most cases, though pharmacotherapy, plasmapheresis, and surgical interventions may also be considered in select cases. Supportive measures may include ensuring adequate hydration, monitoring for GI and kidney complications, treating minor symptoms of arthritis, edema, fever, or malaise, eating a bland diet, and discontinuing any drugs suspected of playing a causative role
Joint and soft tissue discomfort may be reduced by giving analgesics, such as Acetaminophen, Ibuprofen, Flurbiprofen, Ketoprofen, and Naproxen. Corticosteroids may be considered in situations like persistent nephrotic syndrome, crescents in more than 50% of glomeruli, severe abdominal pain, and substantial GI hemorrhage.
Treatment regimens have included IV or oral steroids with or without Azathioprine, Cyclophosphamide, Cyclosporine, Angiotensin converting enzyme inhibitors or angiotensin receptor blockers, Dipyridamole, high-dose IV immunoglobulin G (IVIg), Danazol, and fish oil. Plasmapheresis could be effective to delay the progression of kidney disease. His kidney damage can be prevented from progressing further with above drugs including steroids.
Take care. Hope I have answered your question. Let me know if I can assist you further.
Regards,
Dr. Pallavi M., Anesthesiologist
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