Leflunomide Therapy for IgA Vasculitis with Nephritis in Children

Overview

Journal BMC Pediatr

Publisher Biomed Central

Specialty Pediatrics

Date 2021 Sep 9

PMID 34496826

Citations 5

Authors

Ling Hou

Zhou Zhang

Yue Du

Affiliations

Soon will be listed here.

Abstract

Background: Henoch-Schönlein purpura (HSP), also called IgA vasculitis, is a systemic vasculitis characterized by deposits of immunoglobulin A in blood vessels. Renal impairment of these patients is the main determinant of prognosis. The optimal treatment of HSP nephritis (HSPN) in children remains controversial, but many clinicians administer an immunosuppressive agent with a corticosteroid. A previous study reported that leflunomide (LEF) with a corticosteroid was effective for adult patients with HSPN and nephrotic proteinuria. However, data on this treatment in pediatric patients is limited.

Methods: We described our experience at a single center on the use of LEF in 5 pediatric patients who had IgA vasculitis with proteinuria that was nearly 50 mg/kg (nephrotic range) and remained high despite administration of intravenous steroid, and biopsy-proven nephritis. All patients had class II to IIIb lesions based on the International Study of Kidney Disease in Children (ISKDC).

Results: We successfully treated all 5 children who had IgA vasculitis with nephritis using LEF with a corticosteroid. Four patients achieved a complete remission of proteinuria, and 1 patient had significantly reduced proteinuria. The children received LEF for 6 months to 12 months, and none of them had severe adverse events.

Conclusions: To our knowledge, this is the first case series to report successful treatment of pediatric HSPN with LEF in combination with a corticosteroid.

Citing Articles

IgA Vasculitis (Henoch-Schönlein Purpura): An Update on Treatment.

Castaneda S, Quiroga-Colina P, Floranes P, Uriarte-Ecenarro M, Valero-Martinez C, Vicente-Rabaneda E J Clin Med. 2024; 13(21).

PMID: 39518760 PMC: 11546386. DOI: 10.3390/jcm13216621.

Recurrence of Henoch Schoenlein Purpura Nephritis in Children: A Retrospective Study.

Mukanhaire L, Ren X, Liu G, Wang T, Kasumba Y, Zhou X Heliyon. 2023; 9(11):e22501.

PMID: 38034624 PMC: 10687055. DOI: 10.1016/j.heliyon.2023.e22501.

A narrative review of potential drug treatments for nephritis in children with IgA vasculitis (HSP).

Williams C, Lamond M, Marro J, Chetwynd A, Oni L Clin Rheumatol. 2023; 42(12):3189-3200.

PMID: 37755547 PMC: 10640478. DOI: 10.1007/s10067-023-06781-8.

Individualized medication based on pharmacogenomics and treatment progress in children with IgAV nephritis.

Yang X, Li Q, He Y, Zhu Y, Yang R, Zhu X Front Pharmacol. 2022; 13:956397.

PMID: 35935867 PMC: 9355498. DOI: 10.3389/fphar.2022.956397.

Clinico-Epidemiological Profile and Outcome of Children with IgA Vasculitis in Aseer Region, Southwestern Saudi Arabia.

Dawood S, Abodiah A, Alqahtani S, Shati A, Alqahtani Y, Alshehri M Healthcare (Basel). 2021; 9(12).

PMID: 34946420 PMC: 8701005. DOI: 10.3390/healthcare9121694.

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