When are corticosteroids indicated for the treatment of Henoch-Schönlein purpura (IgA vasculitis)?

Updated: Jan 08, 2021
  • Author: Rajendra Bhimma, MBChB, MD, PhD, DCH (SA), FCP(Paeds)(SA), MMed(Natal); Chief Editor: Craig B Langman, MD  more...
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Answer

Corticosteroids may be considered in the following situations:

  • Persistent nephrotic syndrome
  • Crescents in more than 50% of glomeruli
  • Severe abdominal pain
  • Substantial GI hemorrhage
  • Severe soft tissue edema
  • Severe scrotal edema
  • Neurologic system involvement
  • Intrapulmonary hemorrhage

The beneficial effect of methylprednisolone pulses has been shown in patients receiving combinations of multiple immunosuppressive drugs. 

In IgAV nephritis, a disease considered to be benign, long-term follow-up studies showed delayed development of chronic kidney disease in this population in the absence of rapidly progressive glomerulonephritis when steroids and other immunosuppressants were used.


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