The profile and clinical outcomes of patients with renal involvement due to IgA vasculitis: is azathioprine a good option for treatment?

Adv Rheumatol. 2019 May 22;59(1):21. doi: 10.1186/s42358-019-0064-x.

Abstract

Background: The Henoch-Schönlein Purpura (HSP) orIgA vasculitis is the most common vasculitis of childhood and may occur with renal involvement, with hematuria and / or proteinuria, and may cause severe and non-reversible sequelae.

Objectives: To establish the profile of patients with renal involvement due to IgA vasculitisand to describe our experience with the use of azathioprine to treat patients with nephritis.

Methods: Clinical data were retrospectively collected from medical records of patients with IgA vasculitiswho attended the pediatric rheumatology unit between 1995 and 2017. Patients were separated into two groups based on whether or notthey weretreated with non-glucocorticoid immunosuppressants.

Results: From the178 patients with IgA vasculitis,nephritis was found in67 patients (37.6%), 13 of whom receivedtreatment with non-glucocorticoid immunosuppressants. Ten patients responded well to azathioprine and 1 patient to cyclosporine. Forty patients received oral glucocorticoids, whilst 16received intravenous glucocorticoids.

Conclusion: Azathioprine may be beneficial in the treatment of IgA vasculitis with renal involvement.

Keywords: Azathioprine; Childhood; Henoch-Schönlein Purpura; IgA vasculitis; Nephritis; Vasculitis.

MeSH terms

  • Adolescent
  • Antirheumatic Agents / therapeutic use*
  • Azathioprine / therapeutic use*
  • Child
  • Child, Preschool
  • Cyclophosphamide / therapeutic use
  • Female
  • Hematuria / etiology
  • Humans
  • IgA Vasculitis / complications
  • IgA Vasculitis / drug therapy*
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Mycophenolic Acid / therapeutic use
  • Nephritis / drug therapy*
  • Nephritis / etiology
  • Proteinuria / etiology
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antirheumatic Agents
  • Immunosuppressive Agents
  • Cyclophosphamide
  • Mycophenolic Acid
  • Azathioprine