IgA vasculitis (Henoch-Schönlein purpura) nephritis and psoriasis in a child: is there a relationship?
| Autor: | Clara S. B. Gomes, Carolina Cordinhã, Raquel Penteado, Carmen do Carmo, Ana Sofia Vaz |
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| Rok vydání: | 2021 |
| Předmět: |
Púrpura de Schoenlein-Henoch
Arthritis urologic and male genital diseases Nephropathy 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Psoriasis medicine 030203 arthritis & rheumatology Proteinuria urogenital system business.industry Glomerulonephritis IGA General Medicine medicine.disease Diseases of the genitourinary system. Urology IgA vasculitis Immunology RC870-923 Kidney disorder medicine.symptom business Nephritis Systemic vasculitis |
| Zdroj: | Brazilian Journal of Nephrology, Vol 43, Iss 4, Pp 603-607 (2021) |
| ISSN: | 2175-8239 0101-2800 |
| DOI: | 10.1590/2175-8239-jbn-2020-0101 |
| Popis: | Background Psoriasis is a chronic immune-mediated disorder that primarily affects the skin in both adults and children but can also have systemic involvement, particularly with arthritis and kidney injury. IgA nephropathy is the most frequent kidney disorder associated with psoriasis. Approximately one third of all cases of psoriasis begin in childhood, but association between psoriasis and renal disorders has scarcely been reported in pediatric patients. Henoch-Schönlein purpura (HSP) is a systemic vasculitis characterized by IgA deposits in the vessel walls of affected organs and in the mesangium of the kidney. HSP nephritis histopathology is identical to IgA nephropathy. Case report A 6-year-old boy with recent onset of psoriasis developed HSP with kidney involvement, clinically manifested by nephrotic-range proteinuria and hematuria. Kidney biopsy revealed fibrocellular glomerular crescents and mesangial IgA deposits compatible with IgA nephropathy. Treatment with systemic corticosteroids led to the control of hematuria, but as nephrotic-range proteinuria persisted, cyclophosphamide was added, leading to a gradual decrease in proteinuria. Conclusions We propose an underlying common mechanism in the pathogenesis of both HSP and psoriasis, involving a dysregulation of the IgA-mediated immune response, which could predispose to both entities as well as to kidney damage and IgA nephropathy in these patients. |
| Databáze: | OpenAIRE |
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