APPLICATION OF THE 2016 OXFORD CLASSIFICATION ON RENAL BIOPSY IN DIAGNOSIS OF HENOCH SCHONLEIN PURPURA NEPHRITIS AT THE NATIONAL CHILDREN’S HOSPITAL
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Abstract
Introduction and Objective: Henoch-Schonlein purpura (Henoch-Schonlein purpura-HSP) is a systemic infl ammatory vasculitis with IgA deposition causing damage to multiple organ systems in which kidney damage can progress to end-stage renal disease. In the last 5 years (2016-2020), our Pathology Department has diagnosed more than 70 cases of HSP nephritis biopsied in a total of nearly 500 renal biopsy samples. The aim of this study was to evaluate histopathological characteristics according to the updated 2016 Oxford classifi cation on renal biopsy specimens in HSP nephritis at the National Children’s Hospital. Subjects and methods: Retrospective study in 70 children with HSP nephritis, age ≤ 15 years old who had kidney biopsy at the National Children’s Hospital for 5 years (2016-2020). Histopathological features of kidney injury were evaluated on biopsy specimens and classifi ed according to the updated
2016 Oxford classifi cation criteria. Results: In the study with 49 boys and 21 girls, the male: female ratio was 2.3: 1. The mean age of patients who underwent kidney biopsy was 9.58 ± 3.05 years old, th e age group 6-10 years old was the most common (55,7%). According to the updated 2016 Oxford classifi cation, the rates of mesangial hypercellularity (M1), endocapillary proliferation (E1), segmental glomerulosclerosis/adhesion (S1), tubular atrophy/ interstitial fi brosis (T1, T2) and crescent (C1, C2) are 34 (48.6%), 32 (45.7%), 43 (61.4%), 3 (4.3% and 0%) and 47 (51,4% and 15.7%). Conclusion: The Oxford classifi cation applied to the histopathological diagnosis of HSP nephritis
helps to comprehensively assess the glomerular injury scores (M, E, S, C) and tubules, interstitial tissue (T), thereby treatment orientation and disease prognosis.
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Keywords
Henoch-Schonlein purpura, HSP nephritis, children
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