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

Not all presentations of Henoch-Schönlein purpura carry the same renal risk. When biopsy confirms extensive crescent formation alongside impaired kidney function or heavy proteinuria, a specific escalated approach applies.

Clinical scenario

This protocol targets patients with confirmed IgA vasculitis nephritis in whom renal biopsy shows >50% crescents, combined with impaired eGFR (<60 mL/min) or severe persistent proteinuria. This constellation represents a high-severity nephritis subgroup and drives the selection of a specific therapeutic strategy.

Treatment approach (partial)

Management of this severe IgA vasculitis nephritis presentation may involve a targeted biologic therapy. The complete regimen—including sequencing, monitoring guidance, and the full evidence base—is available in the structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

Severe: >50% crescents on renal biopsy and impaired eGFR (<60 mL/min) or severe persistent proteinuria
Rituximab could be used as alternative therapy in refractory or relapsing IgAV.

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