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Objective:To analyze the clinicopathologic features and prognosis of children with Henoch-Sch?nlein purpura nephritis (HSPN).Methods:The clinicopathological data of children with HSPN who were followed up for more than 5 years and underwent renal biopsy in Jinling Hospital affiliated to Medical School of Nanjing University from January 2001 to June 2015 were retrospectively analyzed. The follow-up endpoint event was defined as estimated glomerular filtration rate (eGFR)<90 ml·min -1·(1.73 m 2) -1. Participants were divided into two groups according to whether the children had reached the primary endpoint event or not. Cox proportional hazards model was used to analyze the influencing factors of renal poor prognosis in children with HSPN. Kaplan-Meier survival curve method was used for survival analysis, and log-rank test was used to compare the difference of renal cumulative survival rate between segmental sclerosis/adhesion (S1) group and non-segmental sclerosis/adhesion (S0) group. Receiver operating characteristic curve (ROC curve) and area under the curve ( AUC) were used to evaluate the diagnostic value. Results:A total of 130 children with HSPN were enrolled in the study. The median onset age was 11.7(8.6, 13.3) years old, of whom 71 cases were males (54.6%). At a median follow-up time of 100.0(75.8, 119.0) months, 12 cases (9.23%) with HSPN reached the primary endpoint event. Compared with the non-endpoint event group, the endpoint event group had higher proportion of hypertension, higher levels of 24-hour urinary protein, serum cholesterol, serum uric acid, and serum creatinine, and lower levels of serum albumin (all P<0.05). There was no statistical difference in treatment between the two groups (all P>0.05). In terms of pathological features, compared with the non-endpoint event group, the endpoint event group had higher proportion of mesangial hyperplasia (M1), S1, tubular atrophy/interstitial fibrosis (T1/T2) and Glomerulus-Bowman's capsule adhesion (all P<0.05). Multivariate Cox regression model showed that S1 was significantly correlated with renal poor prognosis ( HR=7.739, 95% CI 1.422-42.114, P=0.018). As was revealed in a Kaplan-Meier plot, renal cumulative survival rate in the S1 group was significantly lower than that in the S0 group (log-rank χ2=17.069, P<0.001). The ROC curve showed S1 accurately predicted the outcome ( AUC=0.710, 95% CI 0.549-0.872) with specificity of 0.667(95% CI 0.349-0.901) and specificity of 0.754(95% CI 0.667-0.829). Conclusions:S1 is an independent risk factor affecting renal poor prognosis and has a diagnostic value.
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IgA vasculitis is a common autoimmune disease mediated by IgA in childhood, which can involve many systems.Henoch-Sch?nlein purpura nephritis(HSPN)is one of the main complications.Both HSPN and IgA nephropathy(IgAN)are common glomerulonephritis in children, but the former is the most common secondary glomerulonephritis and the latter is one of the most persistent diseases in primary glomerulonephritis.There are differences in clinical phenotype and prognosis.This article reviews the relevant literature, and summarizes the similarities and differences in the pathogenesis of HSPN and IgAN, so as to better understand the two diseases.
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Objective:To investigate the clinical significance and the diagnostic value of detecting kidney injury biomarkers in urine and serum of children with Henoch-Sch?nlein purpura nephritis (HSPN).Methods:A total of 216 children with untreated HSPN, who were admitted in Beijing Children′s Hospital of Capital Medical University from January 2018 to December 2019, were recruited in this retrospective study. Two hundred and sixteen healthy children were selected as the healthy control group. We determined the levels of six biomarkers of kidney injury, including transferrin (TRF), immunoglobulin (IgG), microalbumin (mAlb), alpha-1 microglobulin (α1-MG), N-acetyl-β-D-glucosaminidase (NAG) in urine and cystatin C (CysC) in serum. The data from the two groups were analyzed, the diagnostic value of each biomarker was evaluated and a logistic regression model for the diagnosis of HSPN was established. In addition, 60 children with HSPN, who were admitted to our hospital from November 2021 to February 2022 and 60 healthy children, who underwent healthy check up in the same period were included to validate the diagnostic performance of the established logistic model. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of each biomarker.Results:The urine levels of TRF, IgG, mAlb, α1-MG and NAG and the serum level of CysC were significantly higher in the HSPN group than those in healthy control group (all P<0.05). The area under the ROC curve (AUC) of TRF, IgG, mAlb, α1-MG, NAG and the serum levels of CysC was 0.749, 0.719, 0.810, 0.648, 0.828 and 0.790 (all P<0.05). Logistics regression analysis showed that IgG, mAlb and TRF were the three diagnostic determinants of HSPN ( OR=1.083, 1.105, 1.704,all P<0.001), and the AUC was 0.916 of the established logistic model based on these three biomarkers. The sensitivity was 87.4% and the specificity reached 96.2%. The logistic model was validated by independent cohorts, and the AUC was 0.973, the sensitivity was 95.0% and the specificity was 98.3%. Conclusions:The levels of urine TRF, IgG, mAlb, α1-MG, NAG and serum CysC were higher in children with HSPN. The established logistic regression model based on three biomarkers including IgG, mAlb and TRF in this study has satisfactory clinical value in diagnosing HSPN in children.
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Objective:To compare the efficacy and safety of leflunomide(LEF)to mycophenolate mofetil(MMF)and cyclophosphamide(CTX)in the treatment of Henoch-Sch?nlein purpura nephritis(HSPN)in children with nephrotic proteinuria.Methods:Thirty-nine children who were diagnosed as HSPN with nephrotic proteinuria were randomly divided into three groups: LEF group, MMF group and CTX group.Each group had 13 children.Proteinuria, hematuria, adverse effect and cost were followed up at 1, 3, 6 and 9 months of medication.Results:Proteinuria and hematuria were significantly decreased in each group at 1, 3, 6 and 9 months of medication.Compared to CTX group, proteinuria and hematuria in LEF group and MMF group were lower at 9 months.It was probably associated with one child whose proteinuria did not completely return to normal at 9 months and another child who suffered from a relapse of proteinuria and hematuria at 6.5 months in CTX group.The results suggested that the efficacy of LEF and MMF was slightly better than CTX.During the observation period, all children were well tolerated and no serious adverse reactions occurred.One case showed a slight increase of alanine aminotransferase at 1 month, and returned to normal range at 3 months without any medication in MMF group.The cost of LEF group was(8 231±665)RMB and CTX group was(11 523±469)RMB which was significantly lower than(19 953±386)RMB in MMF group.Conclusion:LEF is as effective as MMF and CTX in the treatment of HSPN with nephrotic proteinuria in children.The adverse reactions of LEF are mild, and the cost is cheaper.LEF is worth popularizing in clinical practice.
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Objective:To investigate the role of follicular helper T(Tfh) cells and galactose deficiency IgA 1(Gd-IgA 1) in the children that were suffering from Henoch-Sch?nlein purpura(HSP) and Henoch-Sch?nlein purpura nephritis(HSPN)and the correlation between them. Methods:According to the presence or absence of renal injury, 62 children with HSP were divided into HSP group with 32 children and HSPN group with 30 children.Twenty children who underwent physical examination at outpatients were known as the healthy control group.Flow cytometry was used to measure the proportion of Tfh(CD4 + CXCR5 + PD-1 + ) in peripheral blood.Immunoturbidimetry and ELISA were used to measure the serum levels of IgA 1 and Gd-IgA 1 respectively. Results:(1) The proportion of Tfh cells in peripheral blood and the serum levels of Gd-IgA 1 in both HSP group and HSPN group had significantly increased than those in healthy control group( P<0.01). Compared result of the HSPN group with HSP group, the proportion of Tfh cells in peripheral blood and the serum levels of Gd-IgA 1 in HSPN group were higher than that in HSP group( P<0.05). (2) In the HSPN group, the proportion of peripheral blood Tfh cells and the serum levels of Gd-IgA 1 in group of renal pathology ≥ grade Ⅲ and heavy proteinuria were significantly elevated compared with group of renal pathology < grade Ⅲ and non-heavy proteinuria(<0.01). (3) In the healthy control group, the serum levels of Gd-IgA 1 was positively correlated with the proportion of Tfh cells in peripheral blood and the serum levels of Gd-IgA 1( P<0.05). Conversely, a non-positive correlation was shown in HSP and HSPN groups( P>0.05). Conclusion:The excessive activation of Tfh cells and the serum levels of Gd-IgA 1 may be one of the pathogenesis of HSP/HSPN, the degree of increment of the two factors may be related to the activity and severity of the disease.The mechanism of Tfh cells potentially leading to an increase of Gd-IgA 1 production requires further study.
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Henoch-Sch?nlein purpura(HSP) is a common small vessel inflammation in childhood, and most of them have good prognosis.Due to too many inflammatory factors, the body injury will persist in some severe cases of HSP that hormone alone is difficult to improve symptoms in a short time.Recent studies have found that gamma globulin or blood purification combined with hormone can relieve clinical symptoms more quickly.Plasma exchange and hemoperfusion are commomly used.The purpose of this paper is to review the status of gamma globulin and blood purification treatment in severe HSP.
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Objective To analyze probable risk factors to Henoch-Sch?nlein purpura (HSP) in Tibetan children so as to bring evidences for correct identification of high-risk children in plateau areas. Methods 140 high-altitude Tibetan children with HSP admitted to Shannan People's Hospital of Tibet Autonomous Region from October 2015 to October 2018 were enrolled, and 140 high-altitude Tibetan healthy children and 140 plain area HSP children were selected as the control. Gender, age, family history, allergy, past history (rheumatic disease, autoimmune disease, asthma), clinical phenotype, biochemical markers (antibody positive rate, platelet count and hemoglobin), clinical efficacy and recurrence were retrospective analyzed. The risk factors of HSP in the high-altitude Tibetan children were analyzed by univariate and multivariate Logistic regression analysis. Results It was shown by univariate analysis that the proportion of allergic history and past history of high-altitude HSP children was higher than those of high-altitude healthy children (allergic history: 35.7% vs. 11.4%, past history: 21.4% vs. 5.7%, both P < 0.05). Compared with plain area HSP children, the age of high-altitude HSP children was increased (years old: 6.5±2.3 vs. 5.3±2.2), the clinical phenotype was more complex (37.9% vs. 57.1% for simple skin and limb type, 21.4% vs. 14.3% for abdominal type, 28.6% vs. 21.4% for renal type, 7.1% vs. 5.0% for brain or lung type, 5.0% vs. 2.2% for complex type), the positive rate of antibody was increased (64.3% vs. 50.0%), platelet count was decreased (×109/L: 116.2±12.3 vs. 176.8±35.4), hemoglobin level was increased (g/L: 125.6±15.7 vs. 113.8±10.9), recurrence rate was lower (4.3% vs. 10.7%), and the difference was statistically significant (all P < 0.05). It was shown by multivariate Logistic regression analysis that age, allergic history and past history were independent risk factors for HSP in high-altitude Tibetan children [age: odds ratio (OR) = 1.263, 95% confidence interval (95%CI) = 1.063-1.968; allergic history: OR = 1.765, 95%CI = 1.326-2.452, past history: OR =1.421, 95%CI = 1.102-2.232, all P < 0.05]. Clinical phenotypic and biochemical indexes were important risk factors affecting the clinical efficacy of high-altitude Tibetan HSP children (non-simple skin and limb type: OR = 2.123, 95%CI =1.623-2.869; antibody positive: OR = 1.865, 95%CI = 1.502-2.768; both P < 0.05). Conclusions It is different of HSP occurrence in Tibetan children from plateau and plain areas. Attention should be paid to screening age, allergy history, past history, clinical phenotype, antibody positive and other high risk children. Early and effective intervention can improve clinical curative effect and reduce recurrence.
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Objective To establish the pathological grades of Henoch-Sch?nlein purpura nephriti(s HSPN) in children with diagnostic prediction models by stepwise Fisher discriminant in children. Methods Based on the in-vestigation of 28 clinical indicators from 144 cases with HSPN came from Children′s Hospital of Chongqing Medical University,the sensitive indicators were found and stepwise Fisher discriminant model was established and its accuracy in predicting the pathological classification of HSPN was tested. Results There were 5 laboratory indicators and clini-cal manifestations with different pathological grades of HSPN. In children with pathological gradeⅡ,ⅢandⅣ,5 indi-cators were screened(P<0. 05)and stepwise Fisher discriminant models were established. And the correct rate of comprehensive diagnosis was(61. 371 ± 8. 740)% in 100 random sampling diagnostic simulations;in children with pathological gradeⅢa and Ⅲb,5 indicators were also screened(P<0. 05)and stepwise Fisher discriminant models were established. And the correct rate of comprehensive diagnosis was(68. 015 ± 5. 736)% in 100 random sampling diagnostic simulations. Conclusions The stepwise Fisher discriminant models established in this research have a better diagnostic accuracy in forecasting for pathological grade of HSPN,and have a certain guiding value on early treatment and prognosis evaluation of children with newly diagnosed HSPN.
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Henoch-Sch?nlein purpura ( HSP ) is a well-known systemic vasculitis disease mediated by IgA1 immune complex in children, and the pathogenesis remains unclear. Henoch-Sch?nlein purpura nephritis ( HSPN) is the most serious complication when the kidneys are damaged. It is also the key to determine the prog-nosis of the disease. Due to a combination of genetic,environmental,and infectious factors,IgA1 is abnormally glycosylated during the immune response. Galactose-deficient immunoglobulin A1(Gd-IgA1)is easy to self-ag-gregate and recognized by the antibody to form an immune complex deposited in the glomerular mesangial, which lead to kidney damage. This article reviews the progress of a series of pathogenic mechanisms of IgA1 glycosylation abnormality in HSPN.
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Group A streptococcus ( GAS) is the most common pathogens of human streptococcal infec-tion. It is considered that GAS infection is one of the important factors leading to Henoch-Sch?nlein purpura (HSP). It can promote the occurrence of Henoch-Sch?nlein purpura nephritis(HSPN),and aggravate HSPN. Hemolysin,protease and superantigen involved in the pathogenesis of GAS. Research progress of the relationship between streptococcal infection and HSP and HSPN are summarized as follows.
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Objective To explore the significance of glomerular fibrinogen (Fib) deposition in Henoch-Sch?nlein purpura nephritis (HSPN). Methods The clinical and pathological data of 82 children with HSPN diagnosed by renal biopsy were retrospectively analyzed. The clinical and pathological characteristics of each group were compared according to whether there were glomerular Fib deposition and deposition intensity in the kidney. Results Glomerular Fib deposition was observed in 63 cases (76.83%) in 82 cases, including Fib+23 cases (28.05%), Fib++37 cases (45.12%) and Fib+++3 cases (3.66%), and no deposition had been found in renal tubules. The levels of high sensitivity C reactive protein (hs-CRP), D-Dimer (DD), CD19+CD23+lymphocyte subsets, and urinary albumin to creatinine ratio (UMA/Cr) were significantly different among non-deposition group, mild deposition group and severe deposition group (P<0.01). The levels of hs-CRP and CD19+CD23+in severe deposition groups were significantly higher than those in the mild and non-deposition groups (P<0.05). The level of D-D in the severe and mild deposition group was significantly higher than that in the non-deposition group (P<0.05). The UMA/Cr in the severe deposition group was significantly higher than that in the non-deposition group (P<0.05). Glomerular Fib deposition is positively correlated with IgA deposition (r=0.64, P<0.001). The proportion of glomerular IgG deposition among three groups was significantly different (P<0.05), and the proportion of IgG deposition in the severe group was the highest. Conclusions When children had glomerular Fib deposition, especially in the case of severe Fib deposition and immune dysfunction, inflammatory response and hypercoagulability are more serious and renal function damage may be more serious.
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Objective To investigate whether follicular helper T(Tfh) cells were involved in the development of Henoch-Sch?nlein purpura(HSP) and Henoch-Sch?nlein purpura nephritis(HSPN) in chil-dren through affecting CD40/CD40L axis. Methods Fifty-five subjects were enrolled in this study and di-vided into four groups as follows:22 children with HSP but without renal involvement(Group A),11 chil-dren with HSPN presenting with microhematuria(Group B),11 children with HSPN presenting with micro-hematuria and proteinuria (Group C) and 11 healthy children (control group). Flow cytometry was per-formed to detect the percentages of CD19+B cells and their subsets,CD19+B cells and CD19+CD38+B cells secreting different Ig classes,CD19+CD40+B cells and their subsets and Tfh cells expressing CD40 ligand (CD40L). Results Compared with the control group,the percentages of CD19+CD86+B,CD19+CD138+B and CD40L+Tfh cells significantly increased in Group C(P<0.05) and slightly increased in Groups A and B (P>0.05). No significant difference in the percentages of CD19+B cells, CD19+CD27+B cells, CD19+B cells or CD19+CD38+B cells expressing IgG, IgM, IgD, CD19+B cells or CD19+B cell subsets secreting CD40 was found between the control group and Groups A,B and C(P>0.05). Moreover,the percentages of CD19+B and CD19+CD38+B cells secreting IgA and IgE in Groups A,B and C were higher than those in the control group(P<0.05). Secretion of IgA by CD19+B and CD19+CD38+B cells were positively correla-ted with the expression of CD40L by Tfh cells(P<0.05). Conclusion Tfh cell-mediated abnormal expres-sion of CD40/CD40L might play an important role in the development of HSP and be related to the clinical severity of renal involvement in HSPN.
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Objective Henoch-Sch?nlein purpura(HSP)is a common multisystemic vasculitis in children ,but the exact pathogenesis remains unknown. Pentraxin 3(PTX3),a new kind of inflammatory cytokines,has a strong inflammatory effect,and is involved in occurrence and develop-ment of a variety of autoimmune diseases. The objective of this study is to evaluate the expression of PTX3,interleukin-8(IL-8),tumor necrosis fac-tor-α(TNF-α)and high sensitivity C-reactive protein(hs-CRP)in children with HSP,and explore the clinical significance of PTX3 in HSP devel-opment. Methods Thirty-six children(HSP group)and 17 healthy children(control group)were enrolled in the study. Serum levels of PTX3,IL-8 and TNF-α were detected by enzyme-linked immunosorbent assay. Serum hs-CRP levels were measured by automatic biochemical analyzer. Re-sults The serum levels of PTX3,IL-8,TNF-α,and hs-CRP were up-regulated in HSP group compared with the control group(P0.05). The expression of PTX3,IL-8,TNF-α and hs-CRP in HSP patients had no gender difference(all P>0.05). Con-clusion The high expression of PTX3 is related to the degree of inflammation in children with HSP. The up-regulated expression of PTX3 may play an important role in pathogenesis of HSP in children.
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Objective To investigate the effect of low pH on acid-sensing ion channel 1a( ASIC1a) expression in vascular endothelial cells induced by serum IgA 1 from Henoch-Sch?nlein purpura ( HSP ) children and regulatory role of ASIC1a in it.Methods Human dermal microvascular endothelial cells ( HDMECs) treated by serum IgA1 from children with HSP were incubated in different pH medium .ASIC1a, destrin and α-SM mRNA expressions in HDMECs were evaluated by real-time quantitative polymerase chain reaction (q-PCR).The level of inflammatory cytokines released by vascular endothelial cells was detected by ELISA .Moreover destrin and α-SM protein expres-sion in HDMECs was evaluated by Western blot .Results The results showed that in low pH condition , IgA1 from HSP children could induce the upregulation of ASIC 1a mRNA expression , stimulate IL-8, NO and TM release of vascular endothelial cells of HSP children .And blockers of ASICs could reduce acid-induced cytokine release of vascular endothelial cells .Moreover destrin and α-SM mRNA and protein expression in HDMECs of HSP children significantly decreased when exposure to extracellular acidosis .However blockers of ASICs increased destrin and α-SM mRNA and protein expression in vascular endothelial cells of HSP children .Conclusions These findings showed that activation of ASIC 1a could be involved in the vascular endothelial cell injury of HSP children .Blocking ASIC1a may have a significant protective effect on the inflammatory injury of vascular endothelial cells .
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Henoch-Sch?nlein purpura ( HSP ) is the most common disease with small vasculitis as the main pathological changes in childhood. Gastrointestinal symptoms as the main clinical manifestations are called abdominal type allergic purpura,some children show abdominal symptoms before skin purpura,even without skin purpura during the whole course of disease,which usually leads to misdiagnose. This article summaries the clini-cal diagnosis and treatment progress of abdominal type allergic purpura.
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Objective To investigate the relationship of single nucleotide polymorphism (4G/5G) in the promoter of plasminogen activator inhibitor-1 (PAI-1) and plasma PAI-1 level with gastrointestinal bleeding in Henoch-Sch?nlein purpura (HSP). Methods A total of 524 children with HSP in acute phase were recruited, and divided into gastrointestinal bleeding group (bleeding group, n?=?186) and non-gastrointestinal bleeding group (control group, n?=?338). The genotype frequency of 4G/5G polymorphism, the plasma PAI-1 level, and other parameters related to coagulation and ifbrinolysis were measured and compared between two groups. Results The levels of platelet count (PLT), platelet distribution width (PDW), serum D dimer (DD), serum PAI-1 were signiifcantly higher in the bleeding group than those in the control group, and the levels of mean platelet volume (MPV) and plasma ifbronectin protein of ifbrinogen (FIB) were signiifcantly lower in the bleeding group than those in the control group (P?
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Scholars have focused on the relationship between Henoch-Sch?nlein purpura nephritis and IgA nephropathy in children, when they gradually recognizes the similarities and differences between Henoch-Sch?nlein purpura nephritis and IgA nephropathy in their incentives, genetic factors, renal immunopathology, therapy and so on,with aberrantly glycosylated IgA1 involved in the pathogenesis of Henoch-Sch?nlein purpura nephritis and IgA nephropathy. This paper will review their differences and similarities,along with their relation, according to the research progress.
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Objectives To analysis clinical pathology of organ speciifc IgA vasculitis (IgA nephropathy) and systemic IgA vasculitis (allergic purpura) of purpura nephritis in children. Methods Clinical and pathological data of hospitalized pediatric patients of IgA nephropathy and purpura nephritis were retrospectively analyzed from June 1993 to November 2014. Results There were 405 patients of IgA nephropathy (256 males and 149 females). The ratio of male to female was 1.7:1. The average age was 10.2±2.8 years. The nephrotic syndrome (31.6%) was the most common clinical type, followed by hematuria and proteinuria (27.9%). There were 548 patients of purpura nephritis, 329 males and 219 females. The ratio of male to female was 1.5:1. The average age was 10.2±3.1 years. The hematuria and proteinuria (61.6%) was the most common clinical type, followed by nephrotic syndrome (21.4%). None of the IgA nephropathy progressed to systemic vasculitis (allergic purpura). Conclusions The causes, onset ages and clinical manifestations of IgA nephropathy and allergic purpura may be consistent or overlap, but none of IgA nephropathy (organ speciifcity IgA vasculitis) progressed to allergic purpura (systemic IgA vasculi-tis). IgA nephropathy might have more renal immune disorder mechanisms involved in its pathogenesis.
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Objective To investigate the clinical and pathological features of Henoch-Sch?nlein purpura nephritis (HSPN) in children. Methods The clinical and pathological data of 242 children with HSPN admitted from January 2009 to January 2014 were retrospectively analyzed. Results The most common clinical type was proteinuria and hematuria (135 cases, 55.79%). The mainly pathological types were typeⅡandⅢ. The distribution of pathological types was statistically signiifcant between different clinical types (P=0.000). The patients with normal urine test had the lowest pathological grade. The patients with isolated hematuria and proteinuria mainly had pathological typeⅡ. The patients with hematuria and proteinuria mainly had pathological typeⅢa. The patients with nephrotic syndrome mainly had pathological typeⅢb. The length of the courses at renal biopsy was not statistically signiifcant among different clinical types (P>0.05) and pathological types (P>0.05). The deposition of immune complex in kidney was not statistically signiifcant among different pathological types (P>0.05). The levels of IgA, C3, and platelet count were not statistically signiifcant among different clinical and pathological types (P>0.05). Conclusion The clin-ical classiifcation is related to the pathological grade in children with HSPN.
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ObjectiveTo investigate the changes in plasma myeloperoxidase (MPO), malondialdehyde (MDA), super-oxide dismutase (SOD) and total anti-oxidant capability (T-AOC) of Henoch-Sch?nlein purpura in children.MethodsA total of 80 HSP children hospitalized from November 2013 to April 2014 were selected including 40 cases of arthritis type, 20 cases of abdominal type and 20 cases of nephritis type (HSPN). Meanwhile, 16 healthy check-up children were selected as controls. Plas-ma MPO, T-AOC levels were detected by chemical colorimetry and MDA levels were detected by thiobarbituric acid colorime-try. Plasma SOD levels were measured by hydroxylamine method. Furthermore, 24-hour urine protein and other hematological indices were routinely tested.ResultsThe plasma levels of MPO, MDA, SOD and T-AOC were signiifcantly different among control group, arthritis type group, abdominal type group and HSPN group (F=24.22-126.99, allP=0.000). In comparison to oth-er three groups, the levels of MPO and MDA were signiifcantly increased and the levels of SOD and T-AOC were signiifcantly decreased in HSPN group (P<0.05). Compared with control group, the levels of MPO and MDA were signiifcantly higher and the levels of SOD and T-AOC were signiifcantly lower in arthritis and abdominal type groups (P<0.05). The levels of MPO and MDA in HSPN group were signiifcantly positively correlated with 24-hour urine protein (r=0.695, 0.559; bothP<0.01).Conclu-sionsThe imbalance between oxidation and antioxidant system exists in children with Henoch-Sch?nlein purpura.