Steroids for prophylaxis of Henoch-Schonlein Purpura nephropathy? Follow up of 171 patients

The necessity of the controversially discussed general steroid prophylaxis in Henoch-Schonlein Purpura (HSP) was analysed based on frequency, risk fac tors and prognosis of renal involvement. Case histories and follow up of at least 1.5 years were evaluated in all 171 patients (median age 6 years) in our institution suffering from HSP between 1.1.1987 and 30.6.1997. HSP was frequently manifest with an involvement of joints (64%) and gastrointestin al tract (58%). Renal involvement occured in only 29% of the childeren. Exc epted one girl (age 12 year), all children with renal disease completely re covered. Renal involvement was significantly rarer in young children (16%) and after one week therapy with prednisone (7%). In young children, renal i nvolvement always followed abdominal pain. Conclusion: In our collective, a general preventing of renal disease in HSP was unnecessary. Especially in young children, the most common manifestati on age, renal involvement rarely occured and had always a good prognosis.