Study of beta-thromboglobulin in children with nephritic syndrome

ABSTRACT

The role of platelets in the hypercoagulable state characteristic of nephrotic syndrome [NS] may be of special importance. Thrombocytosis and increased platelet aggregability are suggested to be important determinants of prethrombotic state of NS Beta thromboglobulin [beta-TG] a platelet-specific protein, released upon activation is considered a specific marker of in vivo platelet activation. The aim of the present work was to study beta-TG level in a group of children with idiopathic minimal change NS [MCNS] and the relation between beta-TG level and the degree of hypoalbuminemia and hypercholesterolemia, if any. The study was carried out on 20 children [14 males and 6 females] aged 2-12 years, in the proteinuric phase of idiopathic MCNS diagnosed according to the International Study of Kidney Diseases in Children [ISKDC] criteria [8 were in the initial attack and 12 in relapse]. Ten apparently healthy children of matching age and sex served as a control group. We assessed platelet count, platelet aggregation with ADP and plasma level of beta-TG. Platelet count, percentage platelet aggregation and beta- TG levels were significantly higher in nephrotics compared to controls. Relapsers had significantly higher platelet count and beta-TG level when compared to nephrotics in the initial attack. A significant negative correlation was found between percentage platelet aggregation and beta- TG level, on one hand, and serum albumin level and significant positive correlation with serum cholesterol. So thrombocytosis and platelet hyperfunction may play a role in the increased tendency to thromboembolism in NS and prophylactic anti-platelet treatment may be of value in nephrotic patients with elevated beta-TG level