Yılmaz Dilek, Yenigün Ayşe, Sönmez Ferah, Kurt Ömürlü İmran
Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine , Adnan Menderes University, Aydın , Turkey .
Ren Fail. 2015 Apr;37(3):387-91. doi: 10.3109/0886022X.2014.996087. Epub 2015 Jan 19.
The etiology of minimal-change disease is not fully known, it is believed to be mediated by the immune system. Minimal-change disease also reported as having association with atopy. In this study, atopy history, the levels of serum IgE, and skin prick test in children with steroid-sensitive nephrotic syndrome were investigated.
A group of 30 children (mean age 7.7 ± 2.2 years, 56.6% male) diagnosed with steroid-sensitive nephrotic syndrome were included in the study. Serum immunoglobulin E levels and eosinophil counts were evaluated in children with steroid-sensitive nephrotic syndrome both in relapse and remission. Skin prick test was performed in remission.
Of the 30 children investigated, 11 (36.7%) had a history of atopy. The median serum total IgE levels in nephrotic children in relapse, with (445 IU/mL) and without atopy (310 IU/mL) were significantly higher than those in remission (respectively, 200 IU/mL, p = 0.021, and 42 IU/mL, p = 0.001). The skin prick tests for all the allergens were evaluated as negative in all the patients.
It was thought that increased IgE may reflect the activation of immune mechanism following various stimuli rather than a direct association with atopy in children with steroid-sensitive nephrotic syndrome.
微小病变病的病因尚不完全清楚,一般认为其由免疫系统介导。微小病变病也被报道与特应性有关。本研究调查了激素敏感型肾病综合征患儿的特应性病史、血清IgE水平及皮肤点刺试验结果。
本研究纳入30例诊断为激素敏感型肾病综合征的患儿(平均年龄7.7±2.2岁,男性占56.6%)。对激素敏感型肾病综合征患儿复发期和缓解期的血清免疫球蛋白E水平及嗜酸性粒细胞计数进行评估。在缓解期进行皮肤点刺试验。
在30例被调查的患儿中,11例(36.7%)有特应性病史。复发期有特应性(445 IU/mL)和无特应性(310 IU/mL)的肾病患儿血清总IgE水平中位数显著高于缓解期(分别为200 IU/mL,p = 0.021;42 IU/mL,p = 0.001)。所有患者的所有过敏原皮肤点刺试验结果均为阴性。
在激素敏感型肾病综合征患儿中,IgE升高可能反映了各种刺激后免疫机制的激活,而非与特应性直接相关。