The significance of glomerular fibrinogen deposition in childhood Henoch-Sch?nlein purpura nephritis / 临床儿科杂志

ABSTRACT

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.