Treatment Regimens for Renal Complications of Henoch-Schönlein Purpura: A Systematic Review

Abstract

Background: Henoch-Schönlein purpura (HSP), that recently named as IgA vasculitis, is the most common childhood vasculitis that may be associated with renal complications. The appropriate treatment of these complications is controversial. Methods: In this systematic review study, English and Persian language databases were searched with specified keywords. QUADAS-2 checklist was also used to evaluate the quality of studies. Based on the keywords used in reviewing the information sources of scientific articles, finally 11 studies were selected for analysis and final evaluation. Findings: A total of 722 patients (5.5-9.9 years-old-age) with HSP were included in the study. A treatment regimen of parenteral methylprednisolone followed by oral prednisolone resulted in long-term remission of 79.2 (95 confidence interval between 66.0 and 88.2), however, additional immunosuppressives were required in two studies. 38 and 46.1 were mentioned. In the therapeutic regimen of oral prednisolone alone, a significant improvement of long-term renal function was achieved in comparison with placebo. Administration of parenteral methylprednisolone followed by oral prednisolone and cyclosporine A had the highest effectiveness in terms of improving renal function in the long term. Conclusion: Regimens based on the prescription of prednisolone lead to long-term improvement of renal function in patients with HSP, but the use of other immunosuppressive drugs, especially cyclosporine A, can lead to a significant improvement of the renal function of these patients. © 2026, Isfahan University of Medical Sciences(IUMS). All rights reserved.