Clinical and Pathological Manifestation of Henoch-Schonlein Purpura Nephritis in Children / 实用儿科临床杂志

Objective To study the relationship of clinical manifestation and pathological changes and prognosis in Henoch-Schonlein purpura nephritis(HSPN)in children.Methods Clinical and pathological characteristics of 42 children with HSPN were analysed.Among them,40 children were detected of angiotensin-convertion enzyme(ACE)gene and had been followed up.Results Among them,there were 9 cases of level Ⅰof pathological types,21 cases of level Ⅱ,12 cases of level Ⅲ,but no cases of level Ⅳ.Ⅰand Ⅱ level were found in those cases of clinical manifestation with solitary hematuria and albuminuria.Pathological grades were Ⅰ,Ⅱ and Ⅲ levels in the cases of hematuria and albuminuria.Pathological types of nephrotic syndrome(NS)were Ⅱ and Ⅲ level,which were of more gross hematuria than those of other grades.ACE gene DD had serious pathological damnification.Conclusions Change of pathology cannot only be anticipated by clinical manifestation of HSPN.But if pathological damnification gets more serious,the albuminuria gets more serious.Gross hematuria and albuminuria can serve as indicators of biopsy.NS of ACE DD type have serious pathological damnification.Children with HSPN has favourable prognosis in the future.

Early Diagnosis of Alport′s Syndrome in 5 Children and Literature Reviews / 实用儿科临床杂志

Objective To explore the early diagnosis of Alport′s syndrome(AS).Methods Renal and skin biopsy was carried out in 5 patients who manifested with isolated hematuria and nephritic syndrome(NS).By using indirect immunofluorescence method,the expression of type Ⅳ collagen ? chains was detected on epidermal basement membrane(EBM) and glomerular basement membrane(GBM).Results ?_1 chains on EBM and GBM were expression in all patients,but ?_5 chains on EBM and ?_3,?_5 chains on GBM form 2 female patients were segmental expression.Thus the goal for early diagnosis was achieved.Conclusions ? chains for EBM type Ⅳ collagen and GBM type Ⅳ collegan should be investigated if condition permits for those patients with isolated hematuria,NS(steroid-resistant) and thinned GBM in electron microscopy.It can be useful for diagnosis and differenial diagnosis of AS.

Changes of Serum Growth Hormone,Insulin-Like Growth Factor-Ⅰ and Insulin-Like Growth Factor Binding Portein-3 Levels in Children with Hypothyroidism / 实用儿科临床杂志

Objective To detect the serum growth hormone(GH),insulin-like growth factor-I(IGF-Ⅰ),insulin-like growth factor binging protein-3(IGFBP-3) levels in children with hypothyroidism and explore the change regulation of GH-IGF axis and thyroxine.Methods Fifty-six hypothyroidism children were divided into congonital hypothyroidism(CH)(14 cases) and Hashimoto's thyroiditis(32 cases).Serum GH,IGF-Ⅰ,IGFBP-3 levels of 56 hypothyroidism children before and after luothyroxine sodium L-T4 treatment and 50 normal children were detected with radioimmunoassay or enzyme-linked immunosorbent assay methods.Results Serum IGF-I,IGFBP-3 levels in 9 CH newborn group were lower,and they were normal after thyroxine substitute therapy.But those of 5 children with CH and 32 cases with Hashimoto's thyroiditis were not significantly changed.Conclusions The GH-IGF axis is inordinate in the CH children,which is an important reason of stature short.Early thyroxine substitute therapy is very helpful to maintain normal growth and development of children with CH.