Henoch-Schönlein nephritis associated with streptococcal infection and persistent hypocomplementemia: a case reportReportar como inadecuado

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Journal of Medical Case Reports

, 4:50

First Online: 11 February 2010Received: 31 December 2008Accepted: 11 February 2010DOI: 10.1186-1752-1947-4-50

Cite this article as: Rivera, F., Anaya, S., Pérez-Álvarez, J. et al. J Med Case Reports 2010 4: 50. doi:10.1186-1752-1947-4-50


IntroductionHenoch-Schönlein purpura is a systemic disease with frequent renal involvement, characterized by IgA mesangial deposits. Streptococcal infection can induce an abnormal IgA immune response like Henoch-Schönlein purpura, quite similar to typical acute post-infectious glomerulonephritis. Indeed, hypocomplementemia that is typical of acute glomerulonephritis has also been described in Henoch-Schönlein purpura.

Case presentationWe describe a 14-year-old Caucasian Spanish girl who developed urinary abnormalities and cutaneous purpura after streptococcal infection. Renal biopsy showed typical findings from Henoch-Schönlein purpura nephritis. In addition, she had low serum levels of complement C4 fraction that persisted during follow-up, in spite of her clinical evolution. She responded to treatment with enalapril and steroids.

ConclusionThe case described has, at least, three points of interest in Henoch-Schönlein purpura: 1 Initial presentation was preceded by streptococcal infection; 2 There was a persistence of low serum levels of complement; and 3 There was response to steroids and angiotensin-converting enzyme inhibitor in the presence of nephrotic syndrome. There are not many cases described in the literature with these characteristics. We conclude that Henoch-Schönlein purpura could appear after streptococcal infection in patients with abnormal complement levels, and that steroids and angiotensin-converting enzyme inhibitor could be successful treatment for the disease.

Electronic supplementary materialThe online version of this article doi:10.1186-1752-1947-4-50 contains supplementary material, which is available to authorized users.

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Autor: Francisco Rivera - Sara Anaya - Javier Pérez-Álvarez - Maria D Sánchez de la Nieta - María C Vozmediano - Julia Blanc

Fuente: https://link.springer.com/

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