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过敏性紫癜伴低补体血症。

Henoch-Schönlein purpura with hypocomplementemia.

机构信息

Department of Nephrology, Children's Hospital Affiliated to Soochow University, Suzhou 215003, Jiangsu Province, The People's Republic of China.

出版信息

Pediatr Nephrol. 2012 May;27(5):801-6. doi: 10.1007/s00467-011-2070-z. Epub 2012 Jan 21.

Abstract

BACKGROUND

Abnormalities of the complement system in Henoch-Schönlein purpura (HSP) have been reported, but how this abnormality in the complement system impacts on the prognosis of HSP remains unknown.

METHODS

We retrospectively studied patients hospitalized for HSP in the Children's Hospital Affiliated to Soochow University between October 2010 and May 2011. Patients with HSP and hypocomplementemia were the cases, and those without hypocomplementemia were the HSP controls. Another group of children (n = 50) with upper respiratory tract infections, but without HSP acted as negative controls.

RESULTS

A total number of 338 HSP patients were included in this study (n = 53 cases, n = 285 controls). In the cases, C3 and C4 levels decreased in 29 patients, C3 was low in 6, and C4 in 18. Complement levels returned to normal within 3 months in all HSP patients except one. Case group patients had higher levels of serum IgG and arthralgia, as well as positive titers of antistreptolysin-O. Rates of abdominal pain, gastrointestinal bleeding, Henoch-Schönlein purpura nephritis (HSPN), and serum IgA and IgM levels were similar in the two HSP groups.

CONCLUSION

Hypocomplementemia associated with HSP is a transient phenomenon. The incidence of significant sequelae such as HSPN between patients with and without hypocomplementemia does not differ.

摘要

背景

已有报道称,过敏性紫癜(HSP)患者的补体系统存在异常,但该补体系统的异常如何影响 HSP 的预后尚不清楚。

方法

我们回顾性研究了 2010 年 10 月至 2011 年 5 月期间在苏州大学附属儿童医院住院的 HSP 患儿。将 HSP 伴低补体血症患儿作为病例组,将不伴低补体血症的 HSP 患儿作为 HSP 对照组。另外一组(n=50)患有上呼吸道感染但无 HSP 的患儿作为阴性对照组。

结果

本研究共纳入 338 例 HSP 患儿(病例组 53 例,对照组 285 例)。在病例组中,29 例患儿的 C3 和 C4 水平降低,6 例患儿 C3 水平降低,18 例患儿 C4 水平降低。除 1 例外,所有 HSP 患儿的补体水平在 3 个月内恢复正常。病例组患儿的血清 IgG 水平和关节痛更高,抗链球菌溶血素 O 滴度阳性。腹痛、胃肠道出血、过敏性紫癜肾炎(HSPN)、血清 IgA 和 IgM 水平在两组 HSP 患儿中相似。

结论

与 HSP 相关的低补体血症是一种短暂现象。伴或不伴低补体血症的 HSPN 等严重并发症的发生率在两组患儿中无差异。

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