Hassas Yeganeh Mehrnoush, Sinaei Reza, Yaraghi Aye, Rahmani Khosro, Javadi Parvaneh Vadood, Shiari Reza, Hosseinzadeh Hamid
Pediatric Pathology Research Center, Research Institute for Children Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Pediatrics, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran; Clinical Research Development Unit, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran.
Caspian J Intern Med. 2024 Spring;15(2):287-293. doi: 10.22088/cjim.15.2.287.
Renal involvement is the most damaging long-term complication of Immunoglobulin-A (IgA) vasculitis. In the lack of a definite predictive biomarker for renal involvement, antiphospholipid antibodies (aPL) have been proposed in recent years.
In this prospective cohort of 48 pediatric patients who were admitted with IgA vasculitis from September 2015 to June 2017, two serum samples were taken 12 weeks apart to detect Anti-Phospholipid antibodies. All patients were followed-up for renal involvement for six months.
Renal involvement occurred in 14 out of 48 patients with IgA vasculitis (29.16%). APLs were positive in nine out of 14 patients with IgA vasculitis and renal involvement (64.28%), in contrast to only six out of 34 patients with IgA vasculitis without renal involvement (17.64%). The presence of aPL antibodies was statistically associated with renal involvement (P=0.002). Although, the relationship between both sex (P=0.025) and age (P=0.046) with aPL positivity was statistically significant, performing a modified logistic regression test, the odds ratio was significant between the groups with and without renal involvement only in term of age and aPL positivity).
The presence of aPL antibodies was statistically associated with renal involvement. We found a significant relationship between the age and aPL positivity. Hence, we need multicenter, more extensive cohort studies to reach a better and more accurate conclusion on the relationship between serum aPLs and renal involvement in IgA vasculitis patients.
肾脏受累是免疫球蛋白 A(IgA)血管炎最具损害性的长期并发症。由于缺乏明确的肾脏受累预测生物标志物,近年来有人提出抗磷脂抗体(aPL)。
在这个前瞻性队列研究中,纳入了2015年9月至2017年6月因IgA血管炎入院的48例儿科患者,每隔12周采集两份血清样本以检测抗磷脂抗体。所有患者均随访6个月以观察肾脏受累情况。
48例IgA血管炎患者中有14例发生肾脏受累(29.16%)。14例发生肾脏受累的IgA血管炎患者中有9例aPL呈阳性(64.28%),相比之下,34例未发生肾脏受累的IgA血管炎患者中只有6例呈阳性(17.64%)。aPL抗体的存在与肾脏受累在统计学上相关(P = 0.002)。虽然性别(P = 0.025)和年龄(P = 0.046)与aPL阳性之间的关系在统计学上具有显著性,但进行修正的逻辑回归检验时,仅在年龄和aPL阳性方面,有肾脏受累组和无肾脏受累组之间的优势比具有显著性。
aPL抗体的存在与肾脏受累在统计学上相关。我们发现年龄与aPL阳性之间存在显著关系。因此,我们需要多中心、更广泛的队列研究,以就血清aPL与IgA血管炎患者肾脏受累之间的关系得出更好、更准确的结论。