Kidney nontumor
Associated with systemic conditions
Henoch-Schönlein purpura

Author: Nikhil Sangle, M.D. (see Authors page)

Revised: 21 March 2018, last major update September 2012

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Henoch-Schonlein purpura [title] kidney pathology

Cite this page: Sangle, N. Henoch-Schonlein purpura. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/kidneyhsp.html. Accessed October 16th, 2018.
Definition / general
  • Purpuric skin lesions on extensor arms and legs and buttocks
  • Also abdominal pain, vomiting, GI bleeding, arthralgias, hematuria, proteinuria and nephrotic syndrome
  • Due to systemic small vessel leukocytoclastic vasculitis
  • Most common systemic vasculitis in children
  • Also called anaphylactoid purpura
Clinical features
Case reports
Treatment
Microscopic (histologic) description
    Acute:
  • Leukocytoclastic vasculitis of small vessels due to deposition of IgA immune complexes
  • Diffuse proliferation of mesangial cells and matrix without significant involvement of capillary walls or lumina
  • Also segmental necrotizing lesions (50%), endocapillary proliferation (13%), cellular crescents, glomerular acute and chronic inflammatory infiltrate

    Chronic:
  • Glomerular sclerosis, tubular loss, interstitial fibrosis and hyaline arteriolosclerosis

    Skin:
  • Hemorrhage and necrotizing vasculitis in dermal small vessels, which contain IgA
  • Vasculitis is present in other organs but usually NOT kidney
Microscopic (histologic) images

Images hosted on other servers:
Missing Image

Various images

Immunofluorescence
  • IgA deposition in mesangium, resembling IgA nephropathy
  • Variable IgG, IgM, C3 and properdin
Immunofluorescence images

Images hosted on other servers:

Henoch-Schönlein
purpura nephritis
Electron microscopy description
  • Mesangial deposits, may extend into subendothelial areas
  • May have subepithelial deposits