Abstract Objective To examine the changes in 25-hydroxyvitamin D3[25- (OH)D3] level in children with Henoch-Schönlein purpura (HSP) and its clinical significance. Methods A total of 92 HSP children were included in this study, and were divided into HSP nephritis (HSPN) group (31 cases) and HSP group (61 cases) based on the presence or absence of HSPN. Alternatively, the patients were divided into purpura alone group (22 cases), purpura with joint symptoms group (joint symptom group, 24 cases), purpura with gastrointestinal symptoms group (gastrointestinal symptom group, 20 cases), and purpura with joint and gastrointestinal symptoms (mixed group, 26 cases) based on their clinical symptoms. In addition, 42 healthy children were selected as healthy control group. The level of 25- (OH)D3 in each group was measured using enzyme-linked immunoassay. Results The 25- (OH)D3 level in the HSP and HSPN groups was significantly lower than that in the healthy control group (P < 0.05), and the 25- (OH)D3 level in the HSPN group was significantly lower than that in the HSP group (P < 0.05). Although there was no significant difference in the 25- (OH) D3 level between the joint symptom, gastrointestinal symptom, and mixed groups (P=0.22), the 25- (OH) D3 level in the three groups was all significantly lower than that in the purpura alone group (P < 0.05). Conclusions The level of 25- (OH)D3 is reduced in children with HSP, particularly those with HSPN or with joint and gastrointestinal symptoms. Therefore, the reduction in 25- (OH)D3 level may serve as a predictor of whether HSP is associated with other impairments.
ZHANG Yuan-Da,DONG Qing-Wei,LI Rong-Min et al. Changes in 25-hydroxyvitamin D3 level in children with Henoch-Schönlein purpura[J]. CJCP, 2017, 19(3): 292-295.
ZHANG Yuan-Da,DONG Qing-Wei,LI Rong-Min et al. Changes in 25-hydroxyvitamin D3 level in children with Henoch-Schönlein purpura[J]. CJCP, 2017, 19(3): 292-295.
Pan YX, Ye Q, Shao WX, et al. Relationship between immune parameters and organ involvement in children with Henoch-Schönlein purpura[J]. PLoS One, 2014, 9(12):e115261.
[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.
Calvo-Rio V, Loricera J, Mate C, et al. Henoch-Schönlein purpura in northern Spain:clinical spectrum of the disease in 417 patients from a single center[J]. Medicine, 2014, 93(2):106-113.
[5]
Jeffery LE, Qureshi OS, Gardner D, et al. Vitamin D antagonises the suppressive effect of inflammatory cytokines on CTLA-4 expression and regulatory function[J]. PLoS One, 2015, 10(7):e0131539.
Liefaard MC, Liqthart S, Vitezova A, et al. Vitamin D and C-reactive protein:a mendelian randomization study[J]. PLoS One, 2015, 10(7):e0131740.
[8]
Calton EK, Keane KN, Newsholme P, et al. The impact of vitamin D levels on inflammatory status:a systematic review of immune cell studies[J]. PLoS One, 2015, 10(11):e0141770.
[9]
Sommer A, Fabri M. Vitamin D regulates cytokine patterns secreted by dendritic cells to promote differentiation of IL-22-producing T Cells[J]. PLoS One, 2015, 10(6):e0130395.
[10]
Chen S, Sims GP, Chen XX, et al. Modulatory effects of 1,25-dihydroxyvitamin D3 on human B cell differentiation[J]. J Immunol, 2007, 179(3):1634-1647.
[11]
Cao N, Chen T, Guo ZP, et al. Elevated serum levels of visfatin in patients with Henoch-Schönlein purpura[J]. Ann Dermatol, 2014, 26(3):303-307.
Sonneveld R, FerrèS, Hoenderop JG, et al. Vitamin D down-regulates TRPC6 expression in podocyte injury and proteinuric glomerular disease[J]. Am J Pathol, 2013, 182(4):1196-1204.
Prathiba Raialakshmi P, Srinivasan K. Gastrointestinal manifestations of Henoch-Schönlein in purpura:A report of two cases[J]. World J Radiol, 2015, 7(3):66-69.
[19]
Terrier B, Derian N, Schoindre Y, et al. Restoration of regulatory and effector T cell balance and B cell homeostasis in systemic lupus erythematosus patients through vitamin D supplementation[J]. Arthritis Res Ther, 2012, 14(5):R221.
[20]
Vojinovic J, Cimaz R. Vitamin D-update for the pediatric rheumatologists[J]. Pediatr Rheumatol Online J, 2015, 13:18.