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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]
IgA Glycosylation
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 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
GI Manifestations 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]
GU Manifestations
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]
HSP Light
Epithelial Crescent
Epithelial Crescents
Immunofluorescence
Electron Microscopy
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
Treatment GI Manifestations
Natural History of Pulmonary Manifestations ,[object Object],[object Object],[object Object],[object Object]
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]
Clinicopathologic Correlation
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]

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