Correlation Of Food Intolerance And Renal Injury In Children With Henoch Schonlein Purpura

Objective：Henoch Schonlein purpura (HSP) is one of the most commonautoimmune reaction mediated systemic vasculitis during childhood withextensive small vessel vasculitis as the main pathological changes. Clinicalmanifestations include: purpura irrelevant with the platelet, abdominal pain,gastrointestinal bleeding, arthritis or arthralgia and nephritis, in which renalinjury is an important factor of influence the prognosis of disease and thepatient’s quality of life. The renal involvement is called Henoch Schonleinpurpura nephritis (HSPN). The role of allergenic foods cannot be ignoredduring many pathogenic factors. Food intolerance is a complex allergicdisease related with IgG. Statistics of the British Allergy Association show thatup to45%of people in the crowd have different degrees of intolerance tosome food, and infants and children have higher incidence than adults. Serumfood-specific IgG antibody levels shall be detected to identify the commonintolerant food and repeated outbreak or exacerbations of HSP can beeffectively prevented by avoiding eating the intolerant food. The paper intendsto provide better objective basis for clinical diagnosis and treatment forchildren by doing research on the relativity between sensitivity of allergensand renal injury which is detected from children’s food intolerance.Methods:1Observed of objects: Selected100children admitted to pediatrics of theSecond Hospital of Hebei Medical University with initial treatment of HenochSchonlein purpura from January2012to March2013. Treatments such asclear infection, anticoagulation, anti allergy and gastric mucosa protection hasbeen offered during hospitalization.Inclusion and exclusion criteria:(1) All selected children are in line with the diagnostic criteria of Henoch Schonlein purpura in the seventh edition of Practical Pediatric written by ZhuFutang, and have no obvious kidney-related clinical manifestations such asedema, hypertension, gross hematuria etc.(2) Exclusion criteria:①Children with primary renal disease, such asNephrotic syndrome, glomerulonephritis, IgA nephropathy etc.②Childrenwith renal damage caused by the presence of other autoimmune diseases, suchas systemic lupus erythematosus, Kawasaki disease, juvenile idiopathicarthritis, etc.③Children with long-term use of hormones, immunosuppressantshistory or recent taking history of renal damage drug.④Children with kidneyor renal vascular malformations, abnormal renal function caused by damage.⑤Children with basic diseases such as heart, lung and brain etc.2Research programme: To master the inner link between the tendency of HSPearly renal injury and food intolerance by detecting observation group eat ingallergen screening，observe the dynamic changes of urinary sediment and the24-hour urinary protein quantitation (monitored once a week, total fourweeks).3Detection Method:3.1Food intolerance screening:Adopt the enzyme-linked immunosorbentassay. IgG in vitro detection kit for14types of food is produced by theAmerican BIOMERICA company, and shall be operated according to the kitinstructions.3.2Urinary sediment：Send morning urine10ml within two hours to thehospital kidney disease laboratory for detection.3.324-hour urine protein quantitation: Empty urine before8:00in the morning,and have24-hours urine specimens collected next8:00in the morning andimmediately send to the hospital biochemical laboratory for examination.3.4Blood pressure monitoring: Measure morning blood pressure one timedaily.3.5Biochemical all items: Completed by the biochemical room of the SecondHospital of Hebei Medical University. 4Statistical analysesAdopt SPSS13.0statistical software to analyze the frequency of differentfood-specific IgG antibodies and the number of renal injury cases in differenttime periods, all counting data shown in constituent ratio or percentage.Analysis on relativity of food intolerance degree, intolerance food types withrenal injury adopt R×X chi-square test, and examine the statistical result withP=0.05as the inspection level to identify the statistical significant.Results：1In antibody positive rate of serum food-specific IgG in100cases, Eggswith animal sources is the highest, reaching78%(78/100); cod fish is thesecond with positive rate48%(48/100); milk with47%(47/100). Plant sourcesmainly include soybean, rice and wheat. Among the researched children, themain intolerant food is the egg, followed by aquatic seafood and milk.2The percentage of cases of renal injury occurred in children withHenoch Schonlein purpura in deferent time is:3%in the first week,25%inthe second week,23%in the third week and14%in the fourth week. Renalinjury is concentrated in2to4weeks.3There is no obvious difference in renal injury degree（P﹥0.05）amongdifferent degrees of food intolerance sensitivities (mild, medium, severe) inchildren with Henoch Schonlein purpura.4There is no obvious difference in renal injury degree（P﹥0.05）amongdifferent food intolerance types in children with Henoch Schonlein purpura.Conclusion:1In100cases, food with the highest antibody positive rate of serumfood-specific IgG is the egg, followed by cod fish and milk.2There is no obvious relativity between food intolerance sensitivity withdifferent degrees and the renal injury degree in children. Not the higher thesensitivity, the more severe degree of kidney.3There is no obvious relativity between food intolerance type and therenal injury degree in children.