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Serum immunoglobulin profiles in Chinese children with Henoch-Schönlein purpura
Jin Wei Ruan1,2, Guo Zhen Fan1, Man Man Niu1
1Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, People's Republic of China.
Insights
Serum immunoglobulin levels, particularly IgA and IgE, are elevated in Henoch-Schönlein purpura (HSP) children. Lower serum IgA may predict HSP relapse, but doesn't correlate with disease activity or kidney issues.
Area of Science:
- Pediatric Nephrology
- Immunology
- Rheumatology
Background:
- Henoch-Schönlein purpura (HSP) is a common childhood vasculitis.
- Immunoglobulin profiles are implicated in HSP pathogenesis.
- Understanding these profiles aids in predicting disease course.
Purpose of the Study:
- To investigate associations between serum immunoglobulin levels (IgA, IgE) and clinical outcomes in pediatric HSP.
- To determine if immunoglobulin levels correlate with disease activity, relapse/recurrence, or renal involvement.
Main Methods:
- Retrospective analysis of 1683 Chinese children diagnosed with HSP.
- Collection of laboratory data (serum IgA, IgE, urine tests) and clinical information.
- Renal biopsy and patient history data were also obtained.
Main Results:
- HSP patients showed significantly elevated serum IgA and IgE levels compared to controls.
- No significant correlation was found between IgA/IgE and disease activity or pathological classification.
- Lower serum IgA levels were associated with a higher incidence of relapse/recurrence in HSP patients.
Conclusions:
- Pediatric HSP is characterized by distinct serum immunoglobulin abnormalities, notably increased IgA and IgE.
- Serum IgA may serve as a potential biomarker for predicting relapse/recurrence in HSP.
- Serum IgA and IgE levels are not reliable indicators of disease activity or renal involvement in pediatric HSP.
Abstract:
The present study focuses on the associations of serum immunoglobulin with disease activity, relapse/recurrence and renal involvement in Henoch-Schönlein purpura (HSP) children. 1683 Chinese children with HSP were recruited from January 2015 to January 2021. Laboratory data of blood samples and urine tests were collected. Renal biopsy was performed by the percutaneous technique. Patients' histories associated with HSP onset were obtained by interviews and questionnaires. (1) IgA and IgE were dramatically elevated in HSP patients as compared to their normal values and subject to a 1.75-3.09 fold and a 1.97-2.61 fold increase, respectively. (2) No significant correlation of the disease activity with IgA and IgE was determined, respectively. (3) The serum IgA levels were significantly lower in patients with relapse/recurrence than that in patients without relapse/recurrence, which may be attributed to the transmission of IgA-mediated immune complexes from blood to vessel walls. (4) No significant correlation was found between serum IgA, IgE levels and the pathological classification. HSP children have marked disorders of serum immunoglobulin profiles, characterized by significant increases in IgA and IgE. The detection of serum IgA may be applicable to predict relapse/recurrence of HSP whereas not associated with disease activity and renal involvement.
