Kidney nontumor

Glomerular disease

IgA related glomerulonephritis

Henoch-Schonlein purpura (HSP)



Topic Completed: 3 September 2012

Minor changes: 10 October 2020

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

Nikhil Sangle, M.D.
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Cite this page: Sangle N. Henoch-Schonlein purpura (HSP). PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/kidneyhsp.html. Accessed October 23rd, 2021.
Definition / general
  • Need clinical history to distinguish between renal limited IgA nephropathy and systemic HSP
  • 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 description
  • 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
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