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Serum IgA/C3 ratio may be a useful marker of disease activity in severe Henoch-Schönlein nephritis
Jae Il Shin1, Jee Min Park, Youn Ho Shin
1Department of Pediatrics, Institute of Kidney Disease, Yonsei University College of Medicine, Seoul, Korea.
Insights
The serum IgA/C3 ratio may help predict disease activity in children with Henoch-Schönlein nephritis (HSN). A decrease in this ratio indicates treatment effectiveness, while an increase suggests ongoing disease activity.
Area of Science:
- Pediatric Nephrology
- Immunology
- Clinical Biomarkers
Background:
- Henoch-Schönlein nephritis (HSN) is a common childhood vasculitis.
- Assessing disease activity and treatment response in HSN is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the serum IgA/C3 ratio as a potential serologic marker for disease activity in pediatric HSN.
- To determine if changes in the IgA/C3 ratio correlate with treatment response and renal biopsy findings.
Main Methods:
- Serum IgA and C3 levels were measured in 12 pediatric HSN patients before and after treatment with steroids and cyclosporine.
- Renal biopsies were performed pre- and post-therapy to assess histologic severity and activity.
- Patients were categorized into complete remission, mild urinary abnormalities, or active renal disease groups post-therapy.
Main Results:
- The serum IgA/C3 ratio significantly decreased in patients achieving complete remission or mild urinary abnormalities post-therapy (p = 0.02).
- Patients with active renal disease showed an increasing trend in the IgA/C3 ratio, though not statistically significant (p = 0.25).
- The post-therapy activity index correlated positively with the change in the serum IgA/C3 ratio (r = 0.635, p = 0.027).
Conclusions:
- The serum IgA/C3 ratio appears to be a valuable marker for predicting disease activity in Henoch-Schönlein nephritis.
- Changes in the serum IgA/C3 ratio may reflect histologic severity and treatment response in pediatric HSN patients.
Background/Aims:
This study was designed to investigate whether the serum IgA/C3 ratio can be a serologic marker of disease activity in children with severe Henoch-Schönlein nephritis (HSN).
Methods:
Twelve HSN patients who were treated with steroids and cyclosporine were examined. The levels of serum IgA and C3 were measured using an international reference preparation (IFCC/CRM470) and a renal biopsy was performed in all patients before and after therapy. After therapy, patients were divided into 3 groups: complete remission (n = 6, group I), mild urinary abnormalities (n = 3, group II), and active renal disease (n = 3, group III).
Results:
The serum IgA/C3 ratio decreased significantly in groups I and II after therapy (2.62 +/- 0.82 vs. 2.02 +/- 0.52, p = 0.02), whereas the ratio in group III increased, although it was not statistically significant (2.13 +/- 0.93 vs. 4.67 +/- 1.71, p = 0.25). A follow-up renal biopsy revealed that the activity index was reduced in groups I and II (7.0 +/- 2.4 vs. 3.6 +/- 1.6, p = 0.016), and not changed in group III (7.3 +/- 2.1 vs. 9.3 +/- 2.5, p = 0.25). The activity index at a follow-up renal biopsy correlated positively with the changes of the serum IgA/C3 ratio: posttherapy activity index = 1.20 x DeltaIgA/C3 + 4.78 (r = 0.635, p = 0.027); where DeltaIgA/C3 is posttherapy IgA/C3--pretherapy IgA/C3.
Conclusion:
These findings suggest that the serum IgA/C3 ratio may be a useful marker to predict disease activity and histologic severity in HSN.
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