Between 1980 and 1994, 38 @entity1 with severe forms of Sch  nlein-Henoch purpura @entity631 were entered into a prospective study to evaluate @entity1667 pulse therapy on the outcome of @entity8 in terms of clinical symptoms and histopathological changes. The @entity1 were considered at risk of developing @entity177 when they presented with a @entity1985 and/or had 50% or more crescentic glomeruli. Initial renal biopsies were obtained from all @entity1 and revealed diffuse proliferative endocapillary @entity631 in 2, focal and segmental @entity631 in 4, and endo- and extracapillary @entity631 in 32, 21 of whom had 50% or more glomeruli with crescents. @entity1 were treated with intravenous pulse @entity1667 (3 days) followed by oral @entity229 (3.5 months). At the latest follow-up, 1-16 years after initiation of therapy, 27 @entity1 had clinically recovered, 3 showed minimal @entity1494 , 4 persistent @entity8 , and 4 had progressed to @entity454 . Sequential renal biopsies were obtained from 30 @entity1 , 7-25 months after initiation of therapy. The clinical outcome correlated well with of the activity (hypercellularity, cellular and fibrocellular crescents, and @entity4 with mononuclear cell infiltrates) and the chronicity (fibrous crescents, @entity8 , @entity194 , and @entity82 ) indexes of post-therapy biopsies. Of particular interest were the post-therapy biopsies of the 18 @entity1 who clinically recovered. They showed a significant decrease of the activity index from 5.1+/-1.1 to 0.4+/-0.8 with a decrease or even a disappearance of IgA deposits, while the chronicity index remained low (0.4+/-0.8 compared with 1.4+/-1). Although uncontrolled, our study suggests that @entity1667 pulse therapy is effective in those @entity1 at risk of progression of their @entity8 , especially if started early during the course of the disease before the crescents become fibrous.

XXXX pulse therapy in the treatment of severe forms of Sch  nlein-Henoch purpura nephritis.

@entity1 :: ('9606', 'Species') :: ['children', 'Patients', 'patients'] @entity1667 :: ('MESH:D008775', 'Chemical') :: ['methylprednisolone'] @entity8 :: ('MESH:D007674', 'Disease') :: ['nephropathy', 'glomerular sclerosis'] @entity82 :: ('MESH:D005355', 'Disease') :: ['interstitial fibrosis'] @entity1494 :: ('MESH:D001745', 'Disease') :: ['urinary abnormalities'] @entity229 :: ('MESH:D011241', 'Chemical') :: ['prednisone'] @entity4 :: ('MESH:D004487', 'Disease') :: ['interstitial edema'] @entity177 :: ('MESH:D051437', 'Disease') :: ['chronic renal failure'] @entity194 :: ('MESH:D001284', 'Disease') :: ['tubular atrophy'] @entity1985 :: ('MESH:D009404', 'Disease') :: ['nephrotic syndrome'] @entity631 :: ('MESH:D005921', 'Disease') :: ['glomerulonephritis'] @entity454 :: ('MESH:D007676', 'Disease') :: ['end-stage renal failure']
@entity1667 :: (MESH:D008775,Chemical) :: ['Methylprednisolone']
