ARCHIVIO CASI


Membranous Glomerulonephritis After Bone
Marrow Transplantation for Multiple Myeloma

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TABLE 1

Renal and isolated ileal involvement in adult Henoch-Schönlein Purpura.
Review of the literature.

 

 
    Author [reference]            (year)

Age at onset

Sex

Clinical

manifestations

Bioptic findings

 

 

 

 

Kidney

Ileum

Skin

Yentis et al [3]

(1973)

27

M

Persistent microscopic haematuria; an episode of frank haematuria.

Abdominal pain, vomiting.

Purpura.

None.

Grossly inflamed and edematous terminal ileum (laparotomy).

None.

Gaskell et al [4]

 (1985)

22

F

Proteinuria (+).

Abdominal pain, anorexia, vomiting and constipation.

Purpura.

Arthralgias.

None.

Multiple small fullthickness  infarcts  (laparotomy).

None.

Chan et al [5]

(1992)

57

F

Microscopic haematuria and red cell casts at onset; subsequently rapidly progressive renal failure.

Abdominal pain, diarrhoea.

Purpura.

Arthralgias.

Focal necrotizing GN; mesangial staining  for IgA and C3.

Vasculitis in small to medium-sized arteries (laparotomy).

Leukocytoclastic vasculitis; positive IgA immunofluorescence

Kawasaki et al [6]

(1997)

43

F

Proteinuria (+).

Abdominal pain.

Purpura.

Arthralgias.

None.

Mucosal and submucosal neutrophils infiltration

(endoscopy).

Leukocytoclastic vasculitis

Present case

56

M

Serum creatinine: 1.7 mg/dl (GFR: 60 ml/min);

proteinuria: 5,580 mg/24h; telescopic urinary sediment.

Abdominal pain, diarrhoea.

Purpura.

Arthralgias.

Proliferative diffuse necrotizing GN; loop and mesangial staining for IgA

Leukocytoclastic vasculitis (endoscopy).

Dermal capillaritis; positive IgA immunofluorescence

GN = glomerulonephritis; i.v. = intravenous; GFR = glomerular filtration rate

 

 

 
    Author [reference]            (year)

Treatment

Outcome

 

 

Ileum

Kidney

Yentis et al [3]

(1973)

None.

Remission within

1 month

Unchanged

Gaskell et al [4]

 (1985)

Plasmapheresis              (27 litres total exchange)

Oral prednisolone         (60 mg/day)

Remission within

7 weeks

 

Unknown

Chan et al [5]

(1992)

i.v. hydrocortisone       (100 mg/6h for 2 days);         i.v. methylprednisolone   (1 g/day for 3 days) followed by i.v. methylprednisolone (60 mg/day) and cyclophosphamide        (50 mg/day)

 

 

Kawasaki et al [6]

(1997)

i.v.  corticosteroids        (50 mg/day)

Remission within

1 month

 

Remission within

1 month

Present case

i.v.  methylprednisolone (500 mg/day for 3 days) followed by oral prednisone (1 mg/kg/day);      i.v.  cyclophosphamide (200 mg/day for 3 days) followed by oral cyclophosphamide                   (2 mg/kg/day)

Remission

within

7 days

 

Unchanged

GN = glomerulonephritis; i.v. = intravenous; GFR = glomerular filtration rate

 

 

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