- Two other studies evaluated the role of steroids in the prevention
of delayed renal disease in HSP. Both studies were retrospective.
Corticosteroids had been given for the treatment of abdominal or joint
pain. One study found the incidence of renal disease to be 4.3%
(1/23) in the group treated with steroids and 50% (5/10) in the group
that was not treated with steroids.2 Another study
found the incidence of renal disease to be equal in both groups; 20%
(4/20) in the group who received steroids and 20% (6/30) in the group
that did not receive steroids.5
- In this study, 67% (8/12) of the children with nephritis had no symptoms
one year later. However, children who appear to recover may have
significant renal disease many years later.4
- Corticosteroids have been found to improve abdominal pain and joint
pain in HSP but they do not decrease the time of the acute phase.
There is no proven benefit of corticosteroids in the treatment of established
- Mechanism of renal disease in HSP is largely unknown therefore it
is difficult to postulate how corticosteroids would prevent renal involvement.
- The major risks of corticosteroid treatment in children with HSP is
masking an acute abdomen or intusseception and GI bleed.
- A very large prospective study is needed to determine the effect
of early corticosteroid treatment in preventing renal insufficiency
- Mollica F, LiVolti S, Garozzo R, Russo G: Effectiveness of early prednisone
treatment in preventing the development of nephropathy in anaphylactoid
purpura. European Journal of Pediatrics. 151:140-144,
- Buchanec J, Galanda V, Belakova S, Minarik M, Zibolen M: Incidence
of renal complications in Henoch-Schonlein Purpura Syndrome in Dependence
of an early administration of steroids. International Urology
and Neophrology. 20(4):409-412, 1988.
- Bunchman TE, Mauer SM, Sibley RK, Verier RL: Anaphylactiod purpura:
characteristics of 16 patients who progressed to renal failure.
Pediatric Nephrology. 2:393-397, 1988.
- Goldstein AR, White RHR, Akuse R, Chantler C: Long term follow-up
of childhood Henoch-Schonlein nephritis. The Lancet.
- Saulsbury F, Corticosteroid therapy does not prevent nephritis in
Henoch-Schonlein Purpura. Pediatric Nephrology. 7:69-71,