What are the treatment options for renal disease due to Henoch-Schönlein purpura (IgA vasculitis)?

Updated: Oct 28, 2020
  • 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

A review of randomized clinical trials for any intervention used to improve renal disease in children with IgAV noted that data were very limited except for short-term prednisone; moreover, prednisone had no benefit in preventing serious long-term kidney disease. [102]

The long-term prognosis of IgAV directly depends on the severity of kidney involvement. Patients with IgAV-related kidney dysfunction may benefit from therapy. However, prophylaxis of kidney complications in IgAV, though interesting, is not currently recommended. Treatment of overt IgAV includes methylprednisolone pulse therapy and prednisone and other immunosuppressive medications. If prednisone is used, a regimen consisting of 1-2 mg/kg/day PO for 7 days is recommended. Antihypertensives may be indicated with kidney involvement.


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