Analysis of age-based stratified renal involvement in Tianjin first batch of 430 patients with Omicron variant of novel coronavirus infection / 中华危重病急救医学

Objective:To investigate the incidence and clinical characteristics of renal involvement with Omicron coronavirus infection in age-based stratified patients.Methods:The first batch of 430 convalescent patients with Omicron coronavirus treated in Tianjin First Central Hospital from January 21, 2022 to March 7, 2022 were enrolled in this study. The baseline information, vaccination status and laboratory examination information of patients were extracted in order to analyze the incidence of renal involvement in age-based stratified patients. Multivariate Logistic regression analysis was conducted to determine the risk factors of renal involvement in different age groups.Results:Excluding those younger than 1 year old and those with a history of chronic kidney disease, a total of 421 patients were included. There were 184 males and 237 females with an average age of (36.65±21.28) years. The types of renal involvement included pathological tubular urine (28.9%), proteinuria (16.9%), renal hematuria (14.7%), a slight decrease of estimated glomerular filtration rate (eGFR, 9.3%), renal glycosuria (0.5%). According to their age, all patients were divided into three groups: 113 cases of ≤ 18 years old, 244 cases of 19-59 years old and 64 cases of ≥ 60 years old. Significant difference was founded in the incidence of renal involvement among the three groups. The incidence of proteinuria, pathological tubular urine and slight decline of eGFR in the ≥ 60 years old group were significantly higher than those in the ≤ 18 years old group [28.1% (18/64) vs. 8.0% (9/112), 42.2% (27/64) vs. 19.6% (22/112), 34.9% (22/63) vs. 6.2% (7/113), respectively, all P < 0.01]. The incidence of slight decline of eGFR was significantly higher than that in 19-59 years old group [34.9% (22/63) vs. 4.1% (10/243), P < 0.01]. Multivariate Logistic regression analysis showed that age was significantly correlated with renal involvement after adjusting for the baseline situation, serological indexes and Omicron infection related indexes [odds ratio ( OR) = 1.059, 95% confidence interval (95% CI) was 1.021-1.097, P = 0.002]. Compared with the group ≤ 18 years old, the risk of renal involvement in the group ≥ 60 years old was significantly increased ( OR = 26.245, 95% CI was 1.357-507.458, P = 0.031). Age ≥ 60 years old was an independent risk factor for renal involvement with Omicron coronavirus infection. Conclusions:Although a low incidence of severe cases in Tianjin first batch of 430 patients with Omicron coronavirus infection, there is still a high incidence of renal involvement. Advanced age is the risk factor of renal involvement. We should pay more attention to the renal involvement of elderly with Omicron coronavirus infection.

Clinical analysis of 24 cases of pediatric acute lymphoblastic leukemia with renal involvement as the initial manifestation / 中华实用儿科临床杂志

Objective:To investigate the clinical features and long-term prognosis of pediatric acute lymphoblastic leukemia (ALL) with renal involvement as the initial manifestation, thus enhancing the diagnostic and therapeutic efficacy.Methods:Twenty-four cases of pediatric ALL with renal involvement as the initial manifestation treated in the First Affiliated Hospital of Zhengzhou University from March 2013 to March 2019 were analyzed retrospectively, and their clinical characteristics were analyzed.According to renal imaging examination findings, they were divided into abnormal group and normal group.The differences in clinical features between the two groups were compared, and the cumulative survival rate was evaluated by Kaplan-Meier method.Results:Among 1 030 newly treated cases of pediatric ALL, 24 cases(2.33%) had renal involvement as the initial manifestation, involving 20 males and 4 females, with a male/female ratio of 5∶1 and the median age of 4.3 years (1.3-14.0 years). There were 16 cases of superficial lymph node enlargement and 21 cases of hepatosplenomegaly.Immature cells in peripheral blood were found in 15 cases.Nine cases were examined with abnormal renal imaging, involving 8 cases returned normal after chemotherapy, and 1 died of renal failure.At the end of follow-up on August 1, 2020, there were 9 cases of bone marrow relapse, 11 survival cases, 10 death cases and 3 cases of loss to follow-up.There were no significant differences in the sex, age, immunophenotype, organ infiltration and urinary protein between the two groups (all P>0.05). The proportion of high creatinine level and intramedullary recurrence rate in the abnormal group were significantly higher than those in the normal group [55.6%(5/9 cases) vs.0(0/15 cases), P=0.003; 66.7%(6/9 cases) vs.20.0%(3/15 cases), P=0.036]. The survival analysis indicated that the 3-year cumulative survival in the abnormal group was significantly lower than that of normal group (17.3% vs.72.7%, χ2=4.047, P< 0.05). Conclusions:For children with unexplained renal involvement as the initial manifestation, clinicians should consider the possibility of leukemic renal infiltration or nephrogenic lymphoma.Physical examinations of the liver, spleen and lymph nodes, morphological analysis of peripheral blood cells, bone marrow examination and renal biopsy are important to make a definite diagnosis in time.Children with imaging abnormalities caused by leukemic renal infiltration are more likely to relapse and have a lower survival rate, which may be a poor prognostic factor for ALL.

Clinical Study and Analysis of Kidney Disease in Patients with Hematological Malignancies

Background: Blood-related malignancies are the most common non-renal neoplasms affecting the kidneys. Renal involvementin patients with hematological malignancies varies according to the type of malignancy. The pathogenesis is either due to directinvolvement of the kidney or related to its treatment and/or effects of chemotherapy.Aim of the Study: This study aims to study and analyze the prevalence of kidney involvement in blood-related malignanciesand to observe the clinical and laboratory profile of patients in various hematological malignancies.Materials and Methods: A total of 93 consecutive patients of various hematological malignancies were included such asHodgkin’s disease, non-Hodgkin’s lymphoma, acute and chronic leukemias, and multiple myeloma. The renal involvement wasjudged on analysis of patient’s clinical parameters, urine analysis, biochemical, radiological, and when necessary, histologicalparameters. All the patients were investigated and treated on an established protocol described in literature. Patients wereadvised to give informed written consent followed by a detailed history taking and relevant physical examination. Patients wereasked about special emphasis on urinary symptoms and usage of nephrotoxic drugs.Observations and Results: A total of 93 consecutive patients of various hematological malignancies presenting to oncologyand medicine departments were included. There were 62 (66.66%) were male and 31 (33.33%) were female with a maleto-female ratio of 2:1. The youngest patient was aged 11 years and the eldest one was 81 years with a mean age of 43.13 ±16.2 years. Among 93 patients, 46/85 (49.46%) were diagnosed as leukemias, 27/93 (29.03%) patients had lymphomas, and20/93 (21.50%) patients were diagnosed as multiple myelomas. Acute leukemias were seen in 27/46 (58.69%) of the patientsand chronic leukemias in 19/46 (41.30%) of the patients. Forty-six patients with leukemias acute lymphatic leukemia were 7 inmales (25.92%) and 3 (11.11%) in females making it a total of 10/27 (37.03%), acute myeloid leukemia was 6 (22.22%) inmales and 3 (11.11%) in females with a total of 9/27 (33.33%). Acute basophilic leukemia was observed in 5 (18.51%) malepatients and 3 (11.11%) female patients; total 8/27 (29.62%). Chronic myeloid leukemia was seen in 5/19 (26.31%) male and2/19 (10.52%) female patients; 7/19 (36.84%).Conclusions: All patients with hematological malignancies should be periodically evaluated for renal dysfunction and necessarypreventive measures should be undertaken in such patients, especially when initiated on chemotherapy.

Urine as a promising sample for Leishmania DNA extraction in the diagnosis of visceral leishmaniasis - a review

ABSTRACT Visceral leishmaniasis is a serious and debilitating infection with high fatality rate in tropical and subtropical countries. As clinical symptoms of visceral leishmaniasis are not so specific, confirmatory diagnostic methods with high sensitivity and specificity are needed. Noninvasive methods have been developed using urine as a clinical sample for visceral leishmaniasis diagnosis. In fact, there is a clear correlation between kidney impairment and Leishmania DNA in urine. However, it has been proved that Leishmania nucleic acid may also be isolated from patients without any sign of renal involvement. Even though urine has become a promissing biological sample, it is still not widely used due to several issues, such as (i) incomprehension of the whole renal pathophysiology process in visceral leishmaniasis, (ii) presence of many amplification inhibitors in urine, and (iii) lack of an efficient urinary DNA extraction method. In this article, we performed a literature review to bring a new perspective for Leishmania DNA isolation in urine.

Clinical profile of patients presented with acute kidney injury

Background: Acute kidney injury (AKI) is defined as abrupt and rapid decline in renal filtration function. We have studied cases of AKI in which there was no primary renal involvement. Materials and methods: A hospital based retrospective study of 50 indoor patients was carried out at B J Medical college and Civil Hospital, Ahmedabad to study the cases of acute kidney injury in patients with no primary kidney involvement and their incidence with relation to age, gender, comorbidities, substance abuse and treatment modalities. Results: Total 50 patients of acute kidney injury were analyzed. Peak incidence was found in fourth decade with overall male: female ratio 2:1. The most common etiology was acute gastroenteritis 24% (n=12) followed by infections 40% (n=20). Most of the patients 28% (n=14) who presented with renal failure on admission, resolved with proper fluid resuscitation and antibiotics. Hemodialysis was required in only 6% (n=3) of the patients. Conclusion: Acute gastroenteritis was the most common etiology of acute kidney injury in our study with median age of 45 years with male preponderance.

Analysis of the clinical characteristics of different serotypes of patients with anti-neutrophil cytoplasm antibody-associated vasculitis / 中华风湿病学杂志

Objective This study was aimed to analyze the difference in the clinical features of patients with anti-proteinase-3 anti-neutrophil cytoplasm antibody (PR3-ANCA) and anti-myeloperoxidase (MPO)-ANCA associated vasculitis (AAV);and to discuss the risk factor of relapse.Methods We retrospectively analyzed 103 AAV patients who were diagnosed in Tianjin Medical University General Hospital from January 2010 to May 2016.Based on ANCA serotypes,patients were divided into PR3-ANCA positive,MPO-ANCA positive,both PR3-ANCA and MPO-ANCA negative groups.The difference between the PR3-ANCA and MPO-ANCA groups was analyzed The x2 test and t-test were used for statistical analysis.The Logistic regression analysis was used to evaluate the risk factors of relapse in AAV patients.Results This study included 103 cases of AAV patients,in which,79 (76.7％) patients were with MPO-ANCA and 23 (22.3％) were PR3-ANCA.The MPO-ANCA group had more coronary heart disease than PR3-ANCA group (x2=10.36,P=0.001).The MPO-ANCA group had more pulmonary fibrosis than PR3-ANCA group (x2=12.08,P=0.001).Logistic regres-sion analysis showed that the risk factors of relapse was increase of erythrocyte sedimentation rate (ESR) [OR(95％CI)=9.20(1.06,79.98),P=0.04].Conclusion AAV patients with positive MPO-ANCA and PR3-ANCA are different.

The value of combined detection of LTB4 and LTFA in early diagnosis of renal involvement in children with henoch schonlein purpura and its influence on prognosis / 国际检验医学杂志

Objective To investigate the value of leukotriene B4(LTB4)and leukotriene E4(LTFA)in early diagnosis of renal involvement in children with Henoch Schonlein purpura(HSPN)and its influence on prognosis.Methods A total of 185 children with HSPN were enrolled in our hospital from January 2014 to October 2016.A total of 50 healthy children were selected as control group at the same period.The serum levels of LTB4 and LTFA in all subjects were detected,and their value in early diagnosis of HSPN and its influence on prognosis were analyzed.Results Compared with the control group,the serum levels of LTB4 and LT-FA in children with HSPN were significantly higher(P<0.05),the contents were 987.6 ng/L and 896.3 ng/L,respectively.The AUC of the combined detection of HSPN was 0.899 and the sensitivity was 0.810,which was better than that of LTB4 and LTB4 alone(P<0.05).The average follow-up was(28.4 ± 10.3)months,with grade A prognosis in 133 cases(71.9%),B grade in 47 ca-ses(25.4%),and C grade in 5 cases(2.7%).The rank sum test showed,the prognosis of children with LTB4<987.6 ng/L was better than that of children with LTB4≥987.6 ng/L,the prognosis of children with LTFA<896.3 ng/L was better than that of children with LTFA≥896.3 ng/L.Spearman analysis showed that the content of LTB4 and LTFA was negatively correlated with prognosis(Rs= -0.693 and -0.637,P<0.05).The higher contents of LTB4 and LTFA,the worse the prognosis.Conclusion Combined detection of LTB4 and LTFA has important clinical significance for early diagnosis and prognosis of HSPN.

Applicability of SA-SVM classifier to auxiliary diagnosis of renal involvement in SLE / 军事医学

Objective To establish a computer-aided diagnosis (CAD) model for the classification and diagnosis of systemic lupus erythematosus (SLE) complicated with renal involvement,and to provide a new method for the timely detection and diagnosis of the disease.Methods Simulated annealing(SA) algorithm was used to optimize the penalty coefficient C and kernel function parameter g of the support vector machines(SVM) algorithm before an SA-SVM classifier model was established and was applied to the intelligent assistant diagnosis of SLE.Results Unlike the single SVM classifier,this method never fell into local optimum,and improved the classification accuracy of a classifier.The classification accuracy for SLE with renal involvement was as high as 98.72％.Conclusion The experimental results show that this classification model is well applicable to the intelligent diagnosis of SLE with renal involvement.

Clinicopathologic characteristics and prognosis of Sj(o)gren's syndrome complicated with renal involvement / 中华风湿病学杂志

Objective To analyze the clinical manifestations,immunological characteristics,pathological changes and prognosis in primary Sj(o)gren's syndrome complicated with renal involvement.Methods Three hundred and eighty-seven patients with pSS were enrolled in this retrospective study.Among these patients,198 patients were complicated with renal involvement and 189 patients without renal involvement.The data of the two groups were analyzed for clinical manifestations,blood tests,urine tests and immunological characteristics by independent sample t test,x2 test,Fisher exact probability and Logistic regression model respectively.Seventy-two patients in the group with renal involvement had kidney biopsies.Results The average of these 387 patients (female/male 345/42 cases) were (55.3±13.2) years old.The average age of 198 patients with renal involvement (female/male 168/30 cases) was (55.3±13.2) years old.The serum RF and IgG of the group with renal volvement was significantly higher than the patients without renal involvement.In the 198 patients with renal involvement;102 patients (51.5％) developed type Ⅰ renal tubular acidosis (RTA Ⅰ).Among these RTA Ⅰ patients,54 patients presented hypokalemia;12 patients developed hypokalemic plegia,30 patients with urolithiasis,6 patients with osteoporosis;69 patients presented with overt renal glomerulus impairment,36 cases had nephrotic syndrome (NS),and 33 cases had chronic glomerulonephritis;In 81 patients with renal failure,including 27 were stage 1 CKD,18 were stage 2 CKD,9 were stage 3 CKD,15 were stage 4 CKD,12 were stage 5 CKD.Among these patients with renal biopsie,light microscopy showed chronic interstitial nephritis (IN,69/72),mesangial proliferative glomerulonephritis (36/72),hyperplastic and sclerosing glomerulonephritis (9/72),partly sclerosing glomerulonephritis (9/72) and membranous nephropathy (6/72).Immunofluorescent examination revealed:IgG deposition in 21 patients (29.1％),IgA in 21(29.1％),IgM in 33(45.8％),C3 in 12(16.6％),C4 in 18(25％) and C1q in 15(20.8％).Sixty-six cases with renal biopsies were followed for (8-30)months,except the patient died of cerebral bemorrhage,all the other patients survived,and renal functions were steady or improved.Conclusion ① The pSS patients with renal involvement mainly shows interstitial nephritis.However,the occurrence of glomerulonephritis is not rare.② Rheumatoid factor (RF) or IgG is significantly associated with renal involvement in patients with pSS.③ When renal involvement is presents,renal biopsies is a necessary for patients with pSS.

Age of onset as a risk factor of renal involvement in Henoch-Schönlein purpura

BACKGROUND: Henoch-Schönlein purpura (HSP) is the most common vasculitis in children, characterized by triad of symptoms; palpable purpura without thrombocytopenia, abdominal pain, and arthritis. Renal involvement often occur in children with HSP. No data on the renal involvement of children with HSP in Indonesia, especially West Java. OBJECTIVE: To evaluate renal involvement in children with HSP. METHODS: Retrospective study was conducted in children with HSP in Department of Child Health, Hasan Sadikin Hospital, from 2006 to 2011. Characteristics and clinical manifestations was reviewed from medical record. HSP was diagnosed by American College of Rheumatology 1990 criteria or European League Against Rheumatism/Pediatric Rheumatology International Trials Organization/Pediatric Rheumatology European Society 2008. RESULTS: There were 128 patients, consisting of 82 male (64.9%) and 46 female (35.1%) with ratio 1.8:1. Mean age was 7.9 ± 2.9 years old which range from 6 month to 15 years. Peak morbidity was between 5-10 years old. Prevalence of HSP in Hasan Sadikin Hospital tend to raise from 2.7/100,000 in 2008 to 5.2/100,000 in 2010. In most patients (71%) purpura was the first symptom. Seventy-one patients (44.5%) had arthritis and 89 patients (69.5%) had abdominal pain, while renal involvement was in 28 patients (21.8%). Gastrointestinal manifestations tend to manifest in patients less than 5 years old (p = 0.267), while renal involvement tend to manifest in age group 11-15 years old (p = 0.015) with odds ratio 3.1 (95% confidence interval, 1.2-8.1). CONCLUSION: Renal involvement in children with HSP is more common in age group 11 to 15 years old.

The importance of extraintestinal manifestations of inflammatory bowel diseases / 临床儿科杂志

Inlfammatory bowel disease (IBD) is characterized by chronic, relapsing inlfammation of the gastrointestinal (GI) tract. In recent years, the incidence is increasing in the pediatric population. Insufifcient recognition of extraintestinal manifestations (EIMs) of IBD clinically may delay diagnosis. Therefore, improving the recognition of EIMs of IBD has an important signiifcance in its early diagnosis and treatment. The pediatricians should be alerted that renal lesions of EIMs in IBD are mainly immunoglobulin A (IgA) nephropathy and interstitial nephritis.

Síndrome de Prune Belly: diagnóstico y manejo pre y posnatal. Presentación de dos casos / Prune Belly syndrome: diagnosis and prenatal and postnatal management. Report of two cases

El síndrome de Prune Belly es una anomalía congénita rara, caracterizada por presentar: hipoplasia de músculos de pared abdominal, anomalía del tracto urinario y criptorquidia bilateral, el cuadro clínico que desencadena en el recién nacido es variable, dependiendo sobre todo del grado de alteración del sistema urinario. La ultrasonografía es el método de elección en el diagnóstico prenatal. El manejo prenatal de este cuadro, está dirigido fundamentalmente a mejorar la función renal y pulmonar, siendo el tratamiento de elección la descompresión vesico-amniótico temprano a través de la colocación de un catéter doble pigtail. El siguiente artículo presenta 2 casos clínicos que muestran las principales formas clínicas de presentación, diagnóstico prenatal ultrasonográfico y manejo intraútero y postnatal de esta patología.

Prune belly syndrome is a rare congenital anomaly, characterized by having: hypoplasia of abdominal wall muscles, urinary tract anomalies and bilateral cryptorchidism, clinical triggers in newborns varies, depending primarily on the degree of disturbance urinary system. Ultrasonography is the method of choice in prenatal diagnosis. The prenatal management of this picture, is aimed primarily at improving renal function and lung being the treatment of choice vesico-amniotic decompression early through the placement of a double pigtail catheter. This article presents 2 cases showing the main clinical presentations, diagnostic ultrasound and prenatal intrauterine and postnatal management of this condition.

A Case Report of Renal Involvement in Adult-Onset Still's Disease over Age 70

Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disease characterized by spiking fever, arthralgia, salmon pink rash, neutrophilic leukocytosis, and multi-organ involvement. Although renal involvement may appear in some cases of adult Still's disease, onset over 70 years of age with renal involvement has not been described. We report a 73-years-old woman whose illness manifested with fever of unknown origin, massive proteinuria, and multiple lymph nodes enlargement. With proteinuria of 2,650 mg/day, a renal biopsy was performed, and histopathological evaluation yielded the diagnosis of chronic glomerulonephritis (CGN). After excluding infectious disease, malignancy, and other rheumatic disease, AOSD was diagnosed with symptoms including fever over 39.0degrees C for more than a week, leukocytosis, generalized lymphadenopathy, and negative autoantibodies. Proteinuria and fever were improved markedly by high dose glucocorticoids and methotrexate therapy.

Renal Manifestations in 2007 Korean Patients with Behcet's Disease

PURPOSE: Behcet's disease (BD) theoretically affects all sizes and types of blood vessels and results in multi-organ involvement. However, renal BD has not been fully characterized, though the kidneys are histologically rich in blood vessels. MATERIALS AND METHODS: A total of 2007 patients who fulfilled the diagnostic criteria for BD were enrolled in this study. We reviewed the medical records and test results of the BD patients and used univariate and multivariate logistic regression analyses to determine the clinical significance of renal involvement in BD. RESULTS: Among the 2007 BD patients, we noted hematuria in 412 (20.5%) and proteinuria in 29 (1.4%). Univariate analysis showed that the BD patients with hematuria were predominantly female and older, had higher erythrocyte sedimentation rates (ESRs), and more frequently presented with genital ulcerations. BD patients with proteinuria had higher ESR levels compared to BD patients without proteinuria. In the multivariate analysis, age, sex, and ESR were found to be significantly associated with hematuria in BD patients, whereas only ESR was associated with proteinuria in BD patients. We also found that IgA nephropathy was the most common pathologic diagnosis in 12 renal BD patients who underwent renal biopsies. CONCLUSION: We suggest that routine urinalysis and serum renal function tests be performed for the early detection of renal BD, especially in older female BD patients with recurrent hematuria, high ESR levels, and frequent genital ulcers, as well as in BD patients with proteinuria and high ESR levels.

A Case of Henoch-Schonlein Purpura with Suspicious Focal Bowel Necrosis in an Adult

Henoch-Schonlein purpura (HSP) is a vasculitis of the small vessels of the skin, joints, gastrointestinal tract, and kidneys characterized by immunoglobulin A deposits in the involved organs. HSP is typified by the classic tetrad of purpura, arthralgia, abdominal pain, and renal involvement. It is common in childhood, but may also occur in adults and can be accompanied by severe complications. Gastrointestinal symptoms occur in up to 85% of patients, and gastrointestinal involvement can manifest as severe problems including intussusception, obstruction, and perforation. The disease course is often self-limited, but severe manifestations occasionally require surgical intervention. We report the case of a 24-year-old man with HSP who presented with abdominal pain and vomiting. Computerized tomography revealed thickening of the ileal wall and multifocal disrupted prominent mucosal enhancement. These findings suggested hemorrhagic enteritis and mucosal necrosis. After treatment with high dose corticosteroids, the lesion improved and surgical intervention was avoided. Our experience suggests that corticosteroid therapy may help in controlling HSP with suspicious small bowel necrosis.

Correlation analysis between hypergammaglobulinemia and renal involvement in patients with primary Sj(o)gren's syndrome / 中华风湿病学杂志

Objective To identify the correlation between hypergnmmaglobulinemia (hyper-IgG) and renal involvement in patients with primary Sjogren's syndrome (Pss). Methods The data of all patients admitted to hospital with the diagnosis of Pss were retrospectively analyzed. One way ANOVA and Speannan's correlation analysis were used to compare the clinical characteristics, renal injuries, immunology tests and renal pathological changes between patients with or without hyper-lgG. Results One hundred and thirty Pss cases were enrolled including 8 males and 122 females. Their age ranged from 16 to 68 years with an average of (44±12) years. Forty-one patients with Pss underwent renal biopsy. The preys lenee of Drta and tubular protein was significantly higher in patients with hyper-IgG than those without(P<0.05). Spearman's correlation analysis showed a negative correlation between serum IgG levels and seral potassium level(r=-0.269,P<0.01).Protein electrophoresis results revealed predominantly tubular protein in the hyper-lgG group, on the other hand glomerular protein was found in the normal-IgG group (P<0.05). The occurrence of decreased C4 com-plement concentration was significantly higher in normal-lgG group (P<0.05); Spearman's correlation analysis for biopsied materials showed that there was no significant difference in the Tubular Index (TI) and Glomeru-lar Index(GI) between these two groups. Conclusion Tubular lesions, especially Drta, may be predominant and correlate with hypergammaglobulinemia. There is a correlation between hypergammaglo-bulinemia and the level of renal lesions. Renal acidification capacity in patients with hypergammaglobulinemia should be evaluated.

Transforming growth factor-beta gene promoter polymorphism:its association with renal involvement in Henoch-Scholein Purpura in childhood / 소아과

Purpose: Several cytokines play important roles in the inflammatory process of Henoch-Scholein Purpura (HSP). It is likely that transforming growth factor-beta (TGF-beta) is involved in the pathogenesis of HSP. The purpose of this study is to investigate whether TGF-beta promoter polymorphism is associated with the renal involvement of childhood HSP. Methods: Thirty-four patients younger than 15 years, who had been diagnosed with HSP, as well as 27 controls, were examined. Patients and controls were genotyped for TGF-beta C-509T by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Results: The T allelic frequencies in patients and controls showed no difference (45% vs. 48.8%). No allele or genotype differences between the group of HSP group and control group were observed. The frequencies of TGF-beta 509 genotypes TT, TC, and CC were no different between patients and controls (26% vs. 22%). The TT genotype of polymorphism of the TGF-beta C-509T gene had no relation to the susceptibility of children to HSP and renal involvement in HSP. Conclusion: TGF-beta T allele may not be related to the susceptibility of children to HSP. The TT genotype of polymorphism of the TGF-beta C 509T gene does not appear to have an influence on renal involvement in childhood HSP.

The Effect of Steroid on Renal Involvement in Henoch-Schonlein Purpura

PURPOSE: Henoch-Schonlein Purpura(HSP) is a self-limited systemic small vessel vasculitis, however, renal involvement is considered to contribute to the outcome of this disease. Therefore, identifying the renal risk factors in HSP and prevention of renal involvement are important. The aim of this study is to investigate whether early steroid administration in HSP could reduce the rate of renal involvement. METHODS: We retrospectively studied two hundred children with HSP. We had administrated steroids orally to resolve of severe abdominal pain, joint and scrotal symptoms. We analyzed the relationship between the steroid therapy to relieve systemic symptoms and the subsequent renal involvement in HSP. RESULTS: There were no significant differences in the incidence and duration of renal involvement according to steroid administration and its duration. In HSP patients with renal manifestations, steroid administration group showed a tendency of hematuria and steroid non-administration group showed a tendency of proteinuria, however, we could not find statistically significant differences in each group. There was no significant difference in the duration of purpura presence according to steroid administration. However, persistent purpura increased the incidence and the duration of renal involvement. CONCLUSION: Early steroid administration did not reduce the risk of renal involvement, therefore, steroid could not prevent delayed nephritis in children with HSP. On the other side, persistent purpura, known to be not related to steroid therapy, was associated with renal involvement. We suggest that early steroid administration could not be useful in preventing the renal involvement in HSP.

The Relationship Between Interleukin 1beta Gene Polymorphism and Renal Involvement in Henoch-Schonlein Purpura

PURPOSE: High interleukin-1 beta(IL-1beta) expression in the skin biopsy specimens of patients with Henoch-Schonlein Purpura(HSP) has been observed. We examined IL-1beta gene polymorphism in patients with HSP. The purpose of this study is to examine the relationship between IL-1beta gene polymorphism and renal involvement in HSP. METHODS: Patients from mideast Korea with HSP were studied. All patients had at least 6 months of follow up. Patients and ethnically matched controls were genotyped for IL-1beta gene polymorphism by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). RESULTS: Thirty-four patients(all younger than 15 years old) who had been diagnosed with HSP and 27 controls were examined. No allele or genotype differences between the HSP and control groups were observed. No significant association between the carriage of IL-1beta(-511) T allele and renal involvement(P=0.525, OR:1.417, CI:0.545-3.686) was found. CONCLUSION: In unselected patients with HSP, carriage of IL-1beta(-511) T allele does not appear to influence renal involvement.

A Case of POEMS Syndrome-Renal Involvements of POEMS Syndrome in Korea / 대한신장학회잡지

Renal involvements of POEMS syndrome are not rare. In some reports, almost 50% of patients show proteinuria. There are some case reports of renal involvement in POEMS syndrome in Korea, but there are no reports about clinical features of renal involvement in POEMS syndrome in Korea and its frequency. We report a case of POEMS syndrome with nephropathy and clinical features of renal involvement in POEMS syndrome in Korea. The most frequent symptoms in POEMS syndrome in Korea were polyneuropathy, edema and ascites. Renal involvement was found in 40% of patients. If there were unknown cause of edema and renal failure when combined with polyneuropathy, considerations should be taken into patients for POEMS syndrome even though POEMS syndrome is very rare.