Study Relationship Between Children With Primary Nephrotic Syndrome And Allergic Condition

Objecetive: To study the primary nephrotic syndrome in children withallergic reaction disorders and the relationship between hormone therapyefficacy, clinical analysis, to better guide the clinical treatment, so as toimprove curative effect, reduce recurrence of primary nephrotic syndrome inchildren.Method: Collected from June2012to December2013in the SecondHospital of Hebei Medical University pediatric hospital treatment, and washospitalized for the first time children with primary nephrotic syndromediagnostic standard as the research object, except secondary nephriticsyndrome, such as purpura nephritis, with lupus nephritis, hepatitis Bassociated glomerulonephritis and IgA nephropathy. Set the children withprimary nephrotic syndrome admitted for the first time, a total of48cases, agedistribution of6~12years old,28cases of boy and20cases of girl, to the earlytreatment group. Draw their venous blood3ml in order to test serum IgE andthe eosinophil count and acidophilic granulocyte cationic protein (ECP) beforetreatment. Observe the effect of regular hormone therapy at least three months,and statistical the cases of hormone sensitive nephropathy, hormone resistancenephropathy and hormone dependent nephropathy. Observe that,20casesrecurrence with primary nephrotic syndrome because of the merger allergicreactions, combined with urticaria in11cases, combined with asthma in5cases,4cases of mosquito-bite dermatitis, set these cases to the recurrence group.The recurrence group was randomed and averaged into recurrence group oneand recurrence group two, before treatment of the food allergens screening,except from the allergens to interference, on the basis of kidney diseasetreatment, recurrence group one add with oral cetirizine hydrochloride (5~10mg/day) to allergy, recurrence group two don’t add with oral cetirizine hydrochloride to allergy. Each recurrence group in the same way measuredbefore and after treatment serum IgE, acidophilic granulocyte count, ECP, andrecord24hours urine protein and urine protein disappear days. outpatienthealth physical examination and the recent hormone-free medication historychildren as the control group. Serum IgE, eosinophil count and ECP in earlytreatment group will be compared with thenormal control group and therecurrence group. There will be divided into elevated IgE group and IgEnormal group according to the level of serum IgE, and compare them inHormone sensitive group, hormone resistance group, hormone dependentgroup: going on correlation detection of serum IgE, ECP,24-hour proteinquantitative in the recurrence group; going on food allergen source screeningin group one and group two of the recurrence group, before and after treatment,serum IgE, ECP, urine protein disappear time will be compared in this group.Result:①T he serum IgElevel in early treatment group was significantlyhigher than the normal control group(P<0.05), ECP and eosinophil count werenot statistically significant(P>0.05).②The sensitive degree of hormonetherapy has a relationship with the level of serum IgE in children with primarynephrotic syndrome(P<0.05): Elevated serum IgE of children was sensitive tohormone, Normal serum IgE of children was resistant to steroid or dependence.③The level of serum IgE and ECP in the recurrence group was significantlyhigher than the early treatment group(P<0.05), eosinophil count was notstatistically significant compare with the early treatment group(P>0.05).④Thelevel of serum IgE and24hours urinary protein quantitative were positivelycorrelated in children with primary nephrotic syndrome (F=103.68R=0.92; Y=0.59+0.005X) and there has no obvious correlation between ECP and24hours urinary protein quantitative.⑤20cases of children with food allergensource screening positive for7cases in the recurrence group, and the positiverate is35%.⑥Before treatment, serum IgE and ECP in the group one of therecurrence group was no significant difference compare with grouptwo(P>0.05), after treatment, serum IgE and ECP, urinary protein clearancetime were significantly different(P<0.05).⑦After treatment, Serum IgE and ECP were significantly lower compare with before treatment in group one andgroup two(P<0.05).Conclusion:①Primary nephrotic syndrome in children with elevatedserum IgE levels may be associated with humoral immune function disorder.②T he sensitive degree of hormone therapy has a relationship with the serumIgE in children with primary nephrotic syndrome: Elevated serum IgE weresensitive to hormones, Normal serum IgE was resistant to steroid ordependence. It is conducive to clinical analysis and provide evidence fordetermining disease prognosis and the type of nephritic syndrome.③SerumIgE level in children with primary nephrotic syndrome accompanied byelevated levels of ECP may be the important factor of the recurrence of disease.④The level of serum IgE and24hours urinary protein quantitative werecorrelated in children with primary nephrotic syndrome.⑤Children withprimary nephrotic syndrome is easy to merge allergy disease, there may be asimilar immune pathogenesis.⑥When the recurrence of primary nephroticsyndrome was caused by merging allergic diseases in children, In the treatmentof kidney disease at the same time, should actively treat allergic reactions, soas to better guide the clinical treatment, improve curative effect, reduce therecurrence of nephrotic syndrome.