Abstract:Objective To explore the value of galactose-deficient IgA1 (Gd-IgA1) in the early diagnosis of Henoch-Schönlein purpura nephritis (HSPN) in children. Methods A total of 67 hospitalized children who were definitely diagnosed with HSPN between January and April 2018 and 58 hospitalized children with Henoch-Schönlein purpura (HSP) were enrolled in the study. Twenty children undergoing routine physical examinations served as controls. The levels of serum and urine Gd-IgA1 were determined using ELISA. The receiver operating characteristic curve was used to analyze the value of serum Gd-IgA1 and urine Gd-IgA1/urine creatinine ratio in the diagnosis of HSPN. Results The level of serum Gd-IgA1 and urine Gd-IgA1/urine creatinine ratio in children with HSP or HSPN were significantly higher than those in healthy control group (P < 0.01), with a significantly greater increase observed in children with HSPN (P < 0.01). Serum Gd-IgA1 ≥ 1485.57 U/mL and/or urine Gd-IgA1/urine creatinine ratio ≥ 105.74 were of favorable value in the diagnosis of HSPN. During the six-month follow-up of the 49 children with HSP, the incidence of HSPN was 47% (23/49), which included a 100% incidence in children with serum Gd-IgA1 ≥ 1485.57 U/mL and a 73% incidence in children with urine Gd-IgA1/urine creatinine ratio ≥ 105.74. Conclusions Serum and urine Gd-IgA1 is of favorable clinical value in the early diagnosis of HSPN.
KANG Zhi-Juan,LIU Bo,LI Zhi-Hui et al. Value of galactose-deficient IgA1 in the early diagnosis of Henoch-Schönlein purpura nephritis in children[J]. CJCP, 2019, 21(2): 172-175.
Chen JY, Mao JH. Henoch-Schönlein purpura nephritis in children:incidence, pathogenesis and management[J]. World J Pediatr, 2015, 11(1):29-34.
[2]
Kawasaki Y, Ono A, Ohara S, et al. Henoch-Schönlein purpura nephritis in childhood:pathogenesis, prognostic factors and treatment[J]. Fukushima J Med Sci, 2013, 59(1):15-26.
[3]
Kang Y, Park JS, Ha YJ, et al. Differences in clinical manifestations and outcomes between adult and child patients with Henoch-Schönlein purpura[J]. J Korean Med Sci, 2014, 29(2):198-203.
[4]
Hastings MC, Moldoveanu Z, Suzuki H, et al. Biomarkers in IgA nephropathy:relationship to pathogenetic hits[J]. Expert Opin Med Diagn, 2013, 7(6):615-627.
[5]
Renfrow MB, Mackay CL, Chamlmers MJ, et al. Analysis of O-glycan heterogeneity in IgA1 myeloma proteins by Fourier transform ion cyclotron resonance mass spectrometry:implications for IgA nephropathy[J]. Anal Bioanal Chem, 2007, 389(5):1397-1407.
[6]
Sanders JT, Hastings MC, Moldoveanu Z, et al. Serial galactosedeficient IgA1 levels in children with IgA nephropathy and healthy controls[J]. Int J Nephrol, 2017, 2017:8210641.
[7]
Placzek WJ, Yanagawa H, Makita Y, et al. Serum galactosedeficient-IgA1 and IgG autoantibodies correlate in patients with IgA nephropathy[J]. PLoS One, 2018, 13(1):e0190967.
[8]
Yanagawa H, Suzuki H, Suzuki Y, et al. A panel of serum biomarkers differentiates IgA nephropathy from other renal diseases[J]. PLoS One, 2014, 9(5):e98081.
[9]
Suzuki H, Allegri L, Suzuki Y, et al. Galact-deficient IgA1 as a candidate urinary polypeptide marker of IgA nephropathy[J]. Dis Markers, 2016, 2016:7806438.
Suzuki Y, Matsuzaki K, Suzuki H, et al. Serum levels of galactose-deficient immunoglobulin (Ig)A1 and related immune complex are associated with disease activity of IgA nephropathy[J]. Clin Exp Nephrol, 2014, 18(5):770-777.
[13]
Heineke MH, Ballering AV, Jamin A, et al. New insights in the pathogenesis of immunoglobulin A vasculitis (Henoch-Schönlein purpura)[J]. Autoimmun Rev, 2017, 16(12):1246-1253.
[14]
de Almeida JL, Campos LM, Paim LB, et al. Renal involvement in Henoch-Schönlein purpura:a multivariate analysis of initial prognostic factors[J]. J Pediatr (Rio J), 2007, 83(3):259-266.
[15]
Zickerman AM, Allen AC, Talwar V, et al. IgA myeloma presenting as Henoch-Schönlein purpura with nephritis[J]. Am J Kidney Dis, 2000, 36(3):E19.
[16]
Allen AC, Willis FR, Beattie TJ, et al. Abnormal IgA glycosylation in Henoch-Schönlein purpura restricted to patients with clinical nephritis[J]. Nephrol Dial Transplant, 1998, 13(4):930-934.