Treatment of Henoch-Schönlein Purpura with >50% Crescents on Renal Biopsy and IgA Vasculitis Nephritis

This protocol addresses a severe presentation of Henoch-Schönlein purpura (IgA vasculitis) in which renal biopsy demonstrates extensive crescent formation alongside evidence of impaired kidney function or heavy proteinuria — a combination requiring a specific clinical approach.

Clinical Scenario

IgA vasculitis nephritis with >50% crescents on renal biopsy.

Accompanied by impaired eGFR (<60 mL/min) or severe persistent proteinuria.

Therapeutic Approach

The protocol for this severity level incorporates a plasma exchange-based intervention — the complete structured regimen including all options, selection criteria, and sequencing is available below.

Instant Access to Structured Evidence-Based Regimens

References

Severe: >50% crescents on renal biopsy and impaired eGFR (<60 mL/min) or severe persistent proteinuria.

plasmapheresis and IVIG could be used in resisted cases.

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