Henoch-Schönlein syndrome--paucity of renal disease. Review of 71 children.

Different rates of renal involvement in the Henoch-Schönlein syndrome have been reported in the literature. We assessed renal involvement during the initial attack of this disease in 71 children in northern Israel, and reevaluated 69 of them after an interval of one to eight years. The mean age at onset was higher than in other reports, and there was a clustering of cases in the late summer and early autumn. During the acute phase of the illness, involvement of the kidney was apparent in only seven patients (9.8%), and only one of these (1.4% of those followed up) showed evidence of continuing renal damage. Patients without initial renal involvement did not subsequently develop renal disease. The remarkably low rate of acute and continuing renal damage in our study as compared with other reports may stem from local variations in causative factors. In our experience, long-term follow-up beyond one year seems warranted only in those patients who had renal involvement during the initial attack.