The Serum Levels Of Galactose-deficient IgAl In Children With Henoch-Schonlein Purpura

Objective To further explore the pathogenesis of childhood Henoch–Schonlein Purpura (HSP), specifically the role of galactose-deficient IgA1 (Gd-IgA1) in the course of childhood HSP, this study observed the changes of the serum Gd-IgA1 levels in the acute stage of HSP, and futher evaluated the relationship of those including the serum Gd-IgA1 levels, the clinical manifestation and the others laboratory findings for sheding light on the general corration of the serum Gd-IgA1 levels, the occurrence of and the organic involvement in children with HSP.Methods①Sixty-three children with HSP, admitted in the first Affiliated Hospital of Anhui Medical University from 2009 Jan to 2010 May, were enrolled in the study. The diagnosis of HSP was made according to the European League against Rheumatism (EULAR) criteria in 2005. None of patients had received glucocorticoids and immunosuppressants in one month before hospitalization.②HSP children were classified into three groups according to clinical manifestation: 32 cases with simplicity purpura, 10 cases with gastrointestinal bleeding, 21case HSP with nephritis (HSPN) and 19 healthy children enrolled in this study as control group.③Serum samples were obtained from peripheral vein of all subjects in the morning after overnight fasting. Serum Gd-IgA1 measured by using enzyme linked immunosorbent assay (ELISA).④The results were determined through the positive distribution examination and were described by mean±standard deviation. The significant dieffernce level is p= 0.05. All data were managed with SPSS 13.5 for window. Least-significant difference and Dunnett-t of ANOVA and Pearson correlativity analysis were used. Results①The serum Gd-IgA1 level(mg/1):simplicity purpura 3.73±1.35; gastrointestinal bleeding 3.71±2.17; HSPN group was 5.10±1.21;The control group was 2.53±0.91; The levels of Gd-IgA1 in all HSP groups were significantly higher than in control group (P<0.05), The levels of Gd-IgA1 in HSPN were significantly higher than others (P<0.05)。②The serum Gd-IgA1 /C3 ratio:simplicity purpura 3.22±1.34;gastrointestinal bleeding 3.35±1.82; HSPN group was 4.47±1.32;The control group was 2.55±0.90; The ratio of Gd-IgA1/C3 in HSPN significantly higher than others (P<0.05).③The correlation between the ratio of Gd-IgA1/C3 and Cr in HSPN was positive(r=0.684, p=0.001).Conclution These results indicate the Serum Gd-IgA1 in children with HSP is significantly higher than healthy children, especially in children with HSPN, suggesting Gd-IgA1 may have the closely relationship between the occurrences and the renal injure of HSP. Gd-IgA1/ C3 ratio could be used as one of the useful reference parameters for identifying renal injure in the early stage of HSP.