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<p><b>OBJECTIVE</b>To study the expression and significance of endothelial microparticles (EMPs) in children with Henoch-Schönlein purpura (HSP).</p><p><b>METHODS</b>A total of 100 previously untreated children with HSP were classified to Henoch-Schönlein purpura nephritis (HSPN) group (n=40) and non-nephritis group (n=60). Thirty healthy children who underwent physical examination were enrolled as control group. Serum levels of EMPs, T helper 17 cells (Th17), and interleukin-17 (IL-17) were compared between groups.</p><p><b>RESULTS</b>The HSPN and non-nephritis groups had significantly higher levels of Th17 and IL-17 than the control group, and the HSPN group had the highest levels (P<0.05). The HSPN and non-nephritis groups had a significantly higher level of EMPs than the control group, and the HSPN group had the highest level (P<0.05). In the HSPN group, the levels of Th17 and IL-17 were positively correlated with the level of EMPs (r=0.830 and 0.644 respectively; P<0.05).</p><p><b>CONCLUSIONS</b>EMPs play an important role in the pathogenesis of HSP. The increase in EMPs might be one of the reasons for renal involvement in children with HSP.</p>
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<p><b>OBJECTIVE</b>To investigate the significance of serum cholesterol and fibrinogen (Fib) in evaluating the risk of glomerulosclerosis in children with nephrotic syndrome.</p><p><b>METHODS</b>Sixty-three children with primary nephrotic syndrome were divided into two groups according to their pathological types: minimal change glomerulopathy (MCG) (n=39) and focal segmental glomerulosclerosis (FSGS) groups (n=24). Serum levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-HDL-C and Fib and 24-hour urinary protein excretion were retrospectively analyzed.</p><p><b>RESULTS</b>Serum levels of TC, non-HDL-C, and LDL-C were significantly higher in the FSGS group than in the MCG group (P<0.05), but there were no significant differences in HDL-C, Fib and 24-hour urinary protein excretion between the two groups (P>0.05). According to the results of logistic regression analysis, high levels of LDL-C, non-HDL-C and TC were risk factors for FSGS (P<0.05). In patients whose proteinuria did not disappear after taking enough glucocorticoid for 4 weeks, the level of non-HDL-C was significantly higher in the FSGS group than in the MCG group (P<0.05); there were no significant differences in TC, LDL-C, HDL-C, and Fib between the MCG and FSGS groups (P>0.05).</p><p><b>CONCLUSIONS</b>Serum cholesterol, especially non-LDL-C, is of great significance in evaluating the risk of glomerulosclerosis in children with nephrotic syndrome. There is no sufficient evidence to support serum Fib as a marker for predicting glomerulosclerosis in these children.</p>
Subject(s)
Child , Child, Preschool , Female , Humans , Male , Cholesterol , Blood , Fibrinogen , Glomerulosclerosis, Focal Segmental , Logistic Models , Nephrosis, Lipoid , Nephrotic Syndrome , Blood , Retrospective Studies , RiskABSTRACT
Objective To investigate the clinical,renal pathological characteristics of Henoch Sch(O)nlein purpura nephritis (HSPN) in children.Methods One hundred and sixty-seven children hospitalized with HSPN from Jan.2008 to Dec.2011 in the First Affiliated Hospital of Zhengzhou University were divided into 2 groups by 24-hour urinary protein quantity:group A with 24-hour urinary protein quantity ＜ 25 mg/kg,group B with 24-hour urinary protein quantity ≥ 25 mg/kg.Age of onset,gender,injury time of kidney,clinical manifestations,24-hour urinary protein quantity and renal pathological grades of the 2 groups were collected and analyzed.Results In 167 HSPN children,the ratio of male to female was 1.8:1.0.The ages from 5 to 10 years old accounted for 70.7％.Renal injurytime was from a day to 5 months,91.6％ of the HSPN children occurred renal damage within 1 month.HSPN children had clinical signs of gastrointestinal involvement in 56 cases(33.5％),at the same time,the digestive tract and joint involvement in 52 cases(31.1％).Pathological classification of 6 grades:8 cases(4.8％) of grade Ⅰ ;32 cases(19.2％) of grade Ⅱ ;124 cases (74.3 ％) of grade Ⅲ ;3 cases (1.8％) of grade Ⅳ ; no grade Ⅴ or Ⅵ.Pathologic grade of group B was higher than group A,and the difference was significant (P ＜ 0.05).Conclusions The HSPN children,expecially the boys,were more found with digestive tract injury or multiple organ damage.Most HSPN children occurred renal damage within 1 month.The renal biopsy of HSPN children should be positive,especially when the 24-hour urinary protein quantity is ≥25 mg/kg.
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<p><b>OBJECTIVE</b>To study the difference in clinico-pathological features between IgA nephropathy (IgAN) and Henoch-Schonlein purpura nephritis (HSPN) in children.</p><p><b>METHODS</b>The medical data of 103 children with HSPN and 61 children with IgAN were retrospectively studied.</p><p><b>RESULTS</b>There were no significant differences in age, sex and disease course between the HSPN and IgAN groups (P>0.05). Clinical classification demonstrated that more severe conditions were found in the IgAN group than in the HSPN group and gross hematuria was more common in the IgAN group (P<0.05). Serum creatinine and cholesterol levels were higher in the IgAN group than in the HSPN group (P<0.05). Fibrinogen-related antigen deposition was more common in the HSPN group, while complement 3(C3) deposition was more common in the IgAN group. Interstitial fibrosis, tubular casts and tubular inflammatory infiltration were also more common in the IgAN group (P<0.05).</p><p><b>CONCLUSIONS</b>Significant clinico-pathological differences can be found between HSPN and IgAN in children, and these differences do not support a one disease entity hypothesis.</p>