PATHOLOGICAL IMPROVEMENT OF IGA NEPHROPATHY AND HENOCH-SCHONLEIN PURPURA NEPHRITIS WITH UROKINASE THERAPY

The pathological findings of 13 patients with immunoglobulin A (IgA) n ephropathy or Henoch-Schonlein purpura nephritis before and after urok inase (UK) administration were investigated retrospectively. The mean activity index value decreased significantly at the time of the second biopsy compared with that of the biopsy before UK treatment. The mean chronicity index value, which was considered to reflect the renal out come, before and after UK treatment did not change significantly, alth ough it improved significantly in six patients. Immunofluorescence mic roscopy showed that the immune deposition of C3 decreased, but that of IgA and fibrin-related antigen were unchanged, by UK therapy. These r esults suggest that UK may prevent the mesangial proliferation associa ted with IgA nephropathy and Henoch-Schonlein purpura nephritis not on ly by its fibrinolytic action, but also by other mechanisms, such as d igestion of the mesangial matrices.