Tabel Yilmaz, Inanc Filiz Callak, Dogan Derya Gumus, Elmas Ahmet Taner
Inonu University, Malatya, Turkey.
Iran J Kidney Dis. 2012 Jul;6(4):269-74.
This study aimed to evaluate renal involvement and factors affecting the prognosis in patients with Henoch-Schonlein purpura (HSP).
The outcomes of 107 children diagnosed with HSP who had been followed up for at least 6 months were reviewed.
Renal involvement was observed in 26.1% of the patients. The mean age of the patients with renal involvement was 8.8 ± 4.0 years as compared to 7.1 ± 2.9 years in the patients without renal involvement (P = .02). The risk of renal involvement was found to be significantly higher in the patients who were 10 years old and over (P < .001). In the group with renal involvement, the frequency of scrotal involvement was significantly higher than that of the group without renal involvement (P = .02). The mean serum immunoglobulin A level of the patients with renal involvements was significantly higher (P = .04) and the mean serum complement C3 levels was significantly lower (P = .04) than those of the patients without renal involvement. None of the patients with renal involvement reached end-stage kidney failure. No significant relationship was observed between the development of renal involvement and early steroid treatment.
This study proposes that in old children with HSP, elevated serum immunoglobulin A levels, decreased serum complement C3 levels, and scrotal involvement are associated with renal involvement. We failed to find any effect of steroid treatment on development of renal involvement.
本研究旨在评估过敏性紫癜（HSP）患者的肾脏受累情况及影响预后的因素。
回顾了107例诊断为HSP且随访至少6个月的儿童的结局。
26.1%的患者出现肾脏受累。肾脏受累患者的平均年龄为8.8±4.0岁，而无肾脏受累患者的平均年龄为7.1±2.9岁（P = 0.02）。发现10岁及以上患者肾脏受累的风险显著更高（P < 0.001）。在肾脏受累组中，阴囊受累的频率显著高于无肾脏受累组（P = 0.02）。肾脏受累患者的平均血清免疫球蛋白A水平显著更高（P = 0.04），平均血清补体C3水平显著更低（P = 0.04），均低于无肾脏受累患者。没有肾脏受累患者发展至终末期肾衰竭。未观察到肾脏受累的发生与早期类固醇治疗之间存在显著关系。
本研究表明，在大龄HSP儿童中，血清免疫球蛋白A水平升高、血清补体C3水平降低和阴囊受累与肾脏受累相关。我们未发现类固醇治疗对肾脏受累的发生有任何影响。
