Thickening and stratification of Bowman’s capsule and proliferation of epithelial cells were segmental. Tubular atrophy and interstitial fibrosis had not been seen Smoothened Agonist supplier (Fig. 2c). Immunofluorescence stain revealed IgA deposition (+) in the mesangial region in a mass pattern (Fig. 2d), but no deposits of IgG, C3, Fib, IgM, C4 and C1q. The diagnosis of Henoch-Schonlein purpura nephritis (secondary IgA nephropathy) was made. She was administered 32 mg methylprednisolone and 30 mg leflunomide daily according to the renal pathological findings and clinical presentations,
and the dose of methylprednisolone was reduced gradually at the speed of 4 mg/month. Curative effect was followed-up after half of year, which revealed 24 h urine protein was 0.1 g, haematuria was relieved, serum creatinine was 59.2 μmol/L, and serum albumin and total protein were 44.2 g/L and 69.8 g/L, respectively. Moreover, other clinical
presentations were improved as well. In the literature, glomerular diseases in HSK (Table 1) reported are, respectively, membranous nephropathy,[6-8] focal and segmental glomerulosclerosis,[9-11] membranoproliferative glomerulonephritis, mesangioproliferative glomerulonephritis, and renal amyloidosis. To the best of our knowledge, we are the first to describe the cases of IgA nephropathy or Henoch-Schonlein purpura nephritis (secondary buy PD98059 IgA nephropathy) occuring in a HSK. Both of our HSK patients are youngsters. Our first patient was hospitalized because of elevation of blood pressure. His laboratory
examination findings revealed haematuria and proteinuria, and serum creatinine was close to the upper limit of normal at the author’s hospital. The second patient was admitted to our hospital for Henoch-Schonlein purpura and abnormal laboratory examination findings of haematuria and proteinuria. The urinary protein excretion of the two cases were both more than 1 g/24 h. We thought it was valuable to identify whether they were associated with idiopathic or secondary glomerular disease. Their renal ultrasonography did not show atrophy of the kidney and CT revealed that vascular malformation did not exist around HSKs. These findings of accessory examinations suggested there was no evident Cetuximab contraindication of renal biopsy. Before renipuncture, the two patients had signed informed consent after they were informed of the significance and risks of renipuncture, moreover, renal biopsy was performed by experienced doctors using a standard needle biopsy gun under renal ultrasonic guidance and did not have postoperative complications. Taking their medical history and renal pathological findings into consideration, they were diagnosed with IgA nephropathy and Henoch-Schonlein purpura nephritis (secondary IgA nephropathy), respectively.