Comparison of age-based clinical and abnormal immune parameters in patients with Henoch-Schönlein purpura / 中华血液学杂志

ABSTRACT

Objective@#To explore age-based clinical and immune parameters in Henoch-Schönlein purpura (HSP) to determine clinically useful markers reflecting disease characteristic.@*Methods@#A cohort of 502 patients with HSP were enrolled into this retrospective study to evaluate their clinical and immune data.@*Results@#Majority HSP cases occurred at age ≤14 years and showed significant immune imbalances of ESR, CD3+ cells, CD4+ cells, CD3-CD16+CD56+ cells, CD4+/CD8+ cells, IgG, IgA, IgM, IgE, complements C3/C4 and ASO in the acute phase. Compared to patients aged >14 years, symptoms of joint were more frequent at disease onset in patients aged ≤14 years (20.8% vs 7.6%, χ2=13.547, P<0.001) , and involvement of digestive tract and joint were also more frequent (57.4% vs 33.8%, χ2=24.106, P<0.001; 55.9% vs 32.5%, χ2=23.768, P<0.001, respectively) , but not for involvement of kidney (21.4% vs 51.3%, χ2=42.440, P<0.001) . The patients aged ≤14 years had distinct immune state, reductions of CD3+ cells, CD4+ cells and IgG were more frequent than patients aged >14 years, also increase of ASO (33.1% vs 20.0%, χ2=6.656, P=0.010) , but not increase of IgA (2.6% vs 39.4%, χ2=15.582, P<0.001) . In addition, reduction of IgG and increase of IgE were positively associated with digestive tract involvement (P<0.001, P=0.001, respectively) , reduction of CD3+CD4+ cells and normal IgM were positively associated with joint involvement (P=0.004, P=0.003, respectively) , increase of CD3+CD8+ cells and normal CD3+ cells were positively associated with kidney involvement (P=0.032, P=0.014, respectively) .@*Conclusion@#HSP showed significant immune imbalance in the acute phase, patients between aged ≤14 and >14 years had distinct clinical and immune characteristic, and abnormal immune parameters were significantly associated with organ involvements.