BACKGROUND: Henoch Sch  nlein purpura with @entity1310 (HSN) in adults may cause severe organ injury, but its rarity has contributed to a lack of data. AIM: To evaluate clinical outcomes and risk factors in adult HSN @entity1 . DESIGN: Retrospective analysis. METHODS: Thirty-seven @entity1 with adult HSN attending the Regional @entity1333 Clinic between 1974 and 2004 were assessed. For inclusion, a renal biopsy showing predominant mesangial IgA immune deposits was required, plus at least two of: @entity1910 , @entity4841 , @entity490 . RESULTS: Ten @entity1 (27%) progressed to @entity454 ( @entity454 ). @entity177 rates were highest in the first decade, with survival rate 72% at 5 years, 68% at 10 years and 46% at final review. Risk factors for @entity454 were: @entity644 > or =1 g/day during follow-up (RR 83.8, p = 0.0006); @entity101 at presentation (RR = 53.3, p = 0.0045) and during follow-up (RR = 5.9, p = 0.05); @entity8 at presentation (RR 8.0, p = 0.0015); age <30 years (RR 7.6, p = 0.02); and male sex (RR = 6.0, p = 0.05). Biopsies frequently showed crescents, mostly affecting <50% of glomeruli; their presence predicted @entity454 , as did interstitial @entity82 and @entity194 . Renal remission, in contrast, was also high (43%). Cytotoxics were used in 32%, with no clear effect on outcome. Relapses affecting the classical extra-renal systems were common, but were not associated with declines in renal function. A high proportion of @entity1 (41%) also suffered vasculitic organ injuries outside the classical systems. DISCUSSION: HSN in adults is a serious relapsing disease, causing @entity177 as frequently as in small-vessel ANCA-positive vasculitides. Prognosis and risks differed in this series from those in other countries, including a higher risk of @entity454 than in previous series. Distinct groups developed either @entity454 , or remitted. The absence of clear benefit suggests that corticosteroids should be reserved for @entity1 with serious disease, and that cytotoxics may not be merited for those at high risk of @entity177 .

Henoch Sch  nlein purpura with XXXX in adults: adverse prognostic indicators in a UK population.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity644 :: ('MESH:D011507', 'Disease') :: ['proteinuria'] @entity1310 :: ('MESH:D009393', 'Disease') :: ['nephritis'] @entity8 :: ('MESH:D007674', 'Disease') :: ['renal impairment'] @entity82 :: ('MESH:D005355', 'Disease') :: ['fibrosis'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension'] @entity1910 :: ('MESH:D005076', 'Disease') :: ['purpuric rash'] @entity1333 :: ('MESH:D014657', 'Disease') :: ['Vasculitis'] @entity177 :: ('MESH:D051437', 'Disease') :: ['renal failure', 'Renal failure'] @entity194 :: ('MESH:D001284', 'Disease') :: ['tubular atrophy'] @entity490 :: ('MESH:D015746', 'Disease') :: ['abdominal pain'] @entity4841 :: ('MESH:D018771', 'Disease') :: ['arthralgia'] @entity454 :: ('MESH:D007676', 'Disease') :: ['ESRF', 'end-stage renal failure']
@entity1310 :: (MESH:D009393,Disease) :: ['nephritis']
