[Renal involvement in anaphylactoid purpura with particular reference to serum immunoglobulin].

Eighty-eight children of anaphylactoid purpura were studied in the Department of Pediatrics from September 1979 to September 1987. Fifty-one children without renal involvement recovered rapidly. Seven children with hematuria or proteinuria and fourteen children with both manifestations recovered fully within six weeks also. Two patients with hematuria and proteinuria recovered two months and four months, respectively, after diagnosis. Ten children had persistent hematuria and proteinuria lasting for more than six months; of these five children recovered and four improved; one child died of intracranial hemorrhage and severe infection. Nephrotic syndrome was noted in five children. Most of them (greater than 80%) had persistent proteinuria more than six months. Incidence of renal involvement was correlated with age. Older children especially those of more than nine years old had a higher incidence rate (p less than 0.005). Serum immunoglobulin A (IgA) and immunoglobulin E (IgE) levels were significantly elevated in 44.7% and 36.4% of patients respectively, but neither influenced the incidence of renal involvement or prognosis of renal disease. Elevated serum IgA and IgE levels in acute stage were significantly reduced in 100% and 83% of children when they were followed in convalescent stage (p less than 0.05). The role of IgE deserves further study. Antinuclear antibody was positive in two children without nephritis. Hypertension was noted in fifteen children, all with renal involvement. Hypertension appears to be a good indicator for renal involvement. Antistreptolysin O titer was elevated in 31.7% of children, but had no significant correlation with incidence of renal involvement.