Henoch Schonlein Purpura (2)

Henoch-Schonlein Purpura Jeremy Gitomer MD Division of Pediatric Nephrology

Introduction ,[object Object],[object Object],[object Object]

Introduction ,[object Object],[object Object]

Epidemiology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

IgA Immune System ,[object Object],[object Object],[object Object],[object Object]

Immunoglobulin A Secretory Component is derived from epithelial surface IgA receptors J Chain produced in the plasma cell

Pathogenesis ,[object Object],[object Object],[object Object],[object Object]

Characteristics of Mesangial IgA ,[object Object],[object Object],[object Object],[object Object]

Origin of Deposited IgA ,[object Object],[object Object],[object Object]

Clinical Presentation ,[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical Manifestations of HSP Szer IS. J Rheumatology 1996:23;1661-1665

Influence of Age on Clinical Manifestations Allen et al. Am J Dis Child 1960;99:147-168

Dermatologic ,[object Object],[object Object],[object Object],[object Object]

Dermatologic ,[object Object],[object Object],[object Object],[object Object],[object Object]

Arthralgia ,[object Object],[object Object],[object Object],[object Object]

Gastrointestinal Manifestations ,[object Object],[object Object],[object Object],[object Object]

GI Manifestations ,[object Object],[object Object],[object Object]

Radiographic Findings in 22 Patients with HSP and Abdominal Complaints Glasier et al. AJR: 1981;136:1081-1085

GI Manifestations Glasier et al. AJR: 1981;136:1081-1085

Intussusception and HSP ,[object Object],[object Object],[object Object],[object Object]

GI Manifestations Intussusception Reduced Intussusception Obstructed proximal ileum Glasier et al. AJR: 1981;136:1081-1085

Other GI Manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

GU Manifestations ,[object Object],[object Object],[object Object]

Pulmonary Manifestations ,[object Object],[object Object],[object Object]

CNS Manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Renal Manifestations ,[object Object],[object Object],[object Object],[object Object]

Renal Manifestations ,[object Object],[object Object],[object Object],[object Object],[object Object]

Criteria for Diagnosis of HSP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Differential Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Laboratory Investigation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Laboratory Investigations ,[object Object],[object Object],[object Object],[object Object],[object Object]

Kidney Biopsy ,[object Object],[object Object],[object Object],[object Object],[object Object]

Morphologic Classification of HSP Glomerulonephritis ISKDC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Extrarenal Pathology ,[object Object],[object Object],[object Object],[object Object]

Natural History for HSP without Nephritis ,[object Object],[object Object],[object Object],[object Object]

Natural History of GI Manifestations Rosenblum et al. Ped 1987;79:1018-1021

Natural History of Pulmonary Manifestations ,[object Object],[object Object],[object Object],[object Object]

Treatment of Pulmonary Manifestations ,[object Object],[object Object]

Treatment for Neurologic Manifestations ,[object Object],[object Object]

Long Term Renal Outcome of HSN ,[object Object],[object Object],[object Object],[object Object],[object Object]

Long Term Renal Outcome for HSNephritis

Long Term Renal Outcome of HSNephritis Actual Number of patients (Percent of total)

Long Term Renal Outcome of HSNephritis

Oral Steroids to Prevent Nephritis in HSNephritis

Pulse Steroids for HSN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Pediatr Nephrol 1998;12:238-243

Combined Therapy for HSN ,[object Object],[object Object],[object Object],[object Object],[object Object],Pediatr Nephrol 1995;9:6-10.

Plasma Exchange for HSN ,[object Object],[object Object],[object Object],[object Object],[object Object]

Intravenous Gamma Globulin for HSN ,[object Object],[object Object],[object Object],[object Object],[object Object],Nephron 1995;69:327-334

Treatment for Chronic HSN ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Recurrence in Transplant ,[object Object],[object Object],[object Object],[object Object],[object Object],Transplantation 1994;58:1179-1186

Conclusions ,[object Object],[object Object],[object Object],[object Object]

Henoch Schonlein Purpura (2)

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Henoch Schonlein Purpura (2)