Summary： In order to characterize their relationship through clinicopathological comparison between IgA nephropathy and Henoch-Schoenlein purpura nephritis （HSPN）, 31 children with IgA nephrop- athy aged between 3 ...Summary： In order to characterize their relationship through clinicopathological comparison between IgA nephropathy and Henoch-Schoenlein purpura nephritis （HSPN）, 31 children with IgA nephrop- athy aged between 3 to 15 years and 120 children with HSPN aged between 4 to 15 years were compared with each other in clinical manifestation, blood biochemistry, serum immunology and followup study. Renal pathological findings under light microscope, immunofluorescence and electronic microscope were analyzed and also compared between 31 children with IgA nephropathy and 32 biopsied children with HSPN. The results showed that the onset age was over 12 years in 25.8 % children with IgA nephropathy, but only 10 % in HSPN （P〈0.05）. The clinical patterns of IgA nephropathy and HSPN were similar, but extra-renal manifestations were more often in HSPN, all of them had skin purpura, 59 % had gastrointestinal symptoms and 47 % suffered from arthralgia, compared with only abdominal pain in 3.2 % children with IgA nephropathy. The renal pathological investigation showed global sclerosis in 35.5 % of IgA nephropathy and 3.1% of HSPN, mesangial sclerosis in 41.9 % of IgA nephropathy and 6.3 % of HSPN, but endothelial proliferation in 65.6 % of HSPN and 29 % of IgA nephropathy （all P〈0.01）. Thin basement membrane nephropathy was only found in 6. 5 % children with IgA nephropathy, no in HSPN. The electronic dense deposits in HSPN were sparse, lodse and wildly spread in glomerular mesangium, subendothelial area and even intra basement membrane, but it was dense, lumpy and mostly limited in mesangium and paramesangium in IgA nephropathy. Predominant IgA deposits were found in 81.2% of HSPN, and overwhelming IgG deposits in 12.5 % of HSPN with relatively weak IgA deposits, moreover 6.3 % of HSPN showed linear IgG deposits in glomerular capillary. Totally 71. 9 G of HSPN had IgG deposits in glomeruli and only 19.4% of IgA nephropathy showed glomerular IgG deposits （P〈0. 01）. No IgG deposit was observed in 81. 6 % of IgA nephropathy, among them most showed IgA and IgM and/or C3 deposits, moreover overwhelming IgG deposits and linear IgG deposits couldn＇t be found in IgA nephropathy. Mean 20 months follow-up showed complete remission in 72.5% of HSPN, but only 19.4% in IgA nephropathy after 34 months follow-up. Moreover, 64.5 % of IgA nephropathy had consistent hematuria and proteinuria and 16. 1% had active nephritides （P〈0.05）. It was concluded that significant clinico-pathological difference was found between HSPN and IgA nephropathy, which didn＇t support the one disease entity hypothesis. HSPN and IgA nephropathy are probably two diseases with similar immune abnormalities.展开更多
BACKGROUND The incidence of pulmonary embolism(PE) in children is low, but its mortality is high. Hypereosinophilic syndrome(HES) is a group of diseases caused by an abnormal increase in eosinophilic granulocytes resu...BACKGROUND The incidence of pulmonary embolism(PE) in children is low, but its mortality is high. Hypereosinophilic syndrome(HES) is a group of diseases caused by an abnormal increase in eosinophilic granulocytes resulting in multiple-organ dysfunction. The urgent event of thromboembolism in the pulmonary region provoked by eosinophils in idiopathic HES(IHES) is relatively unusual. This article reports a case of IHES with multiple PEs and left leg venous thrombosis as the first manifestation. One month later, the patient developed Henoch-Schonlein purpura(HSP), which is very rare.CASE SUMMARY We report the case of a 12-year-old boy who was admitted to the hospital with dyspnea, left leg pain, and aggravation. He had bilateral PE and left leg venous embolism with mild eosinophilia. Low-molecular-weight heparin and urokinase were given. At the same time, the interventional department was contacted about filter implantation, followed by urokinase thrombolysis. The left leg thrombus was aspirated under ultrasound guidance. He was discharged from the hospital on rivaroxaban. One month later, he developed a rash on both legs and ankle pain consistent with HSP, with severe eosinophilia and motor and sensory disturbances. The patient was diagnosed with IHES with multiple embolisms complicated by HSP after excluding other causes of the eosinophil elevation. After glucocorticoid treatment, the symptoms were relieved, but the patient later developed purpura nephritis.CONCLUSION We report a rare and life-threatening case of IHES with multiple embolisms associated with HSP.A mild elevation of eosinophils early in the disease leads to difficulties in diagnosis and delayed treatment.展开更多
BACKGROUND Purpura nephritis,also called Henoch-Schönlein purpura nephritis,is a systemic disease with small dead vasculitis as the main pathological change.AIM To observe the influence of transitional nursing ac...BACKGROUND Purpura nephritis,also called Henoch-Schönlein purpura nephritis,is a systemic disease with small dead vasculitis as the main pathological change.AIM To observe the influence of transitional nursing activities on the compliance behaviors and disease knowledge of children with purpura nephritis.METHODS A total of 82 children with purpura nephritis were included and divided into a general nursing group(41 children)and transitional nursing group(41 children)using the envelope method.The general nursing group received routine nursing care,while the transitional nursing group received transitional nursing care.The behaviors,knowledge of the disease,and self-management ability of the two groups were evaluated after nursing care was provided.RESULTS The scores of four items(self-care ability,self-responsibility,health knowledge level,and self-concept)in the transitional nursing group were significantly higher than those in the general nursing group.CONCLUSION Transitional nursing can directly improve the disease knowledge level and selfmanagement ability of children with purpura nephritis and effectively reduce complications.展开更多
The clinical spectrum of immunoglobulin A vasculitis nephritis(IgAVN)ranges from the relatively common transitory microscopic hematuria and/or low-grade proteinuria to nephritic or nephrotic syndrome,rapidly progressi...The clinical spectrum of immunoglobulin A vasculitis nephritis(IgAVN)ranges from the relatively common transitory microscopic hematuria and/or low-grade proteinuria to nephritic or nephrotic syndrome,rapidly progressive glomerulonephritis,or even renal failure.Clinical and experimental studies have shown a multifactor pathogenesis:Infection triggers,impaired glycosylation of IgA1,complement activation,Toll-like-receptor activation and B cell proliferation.This knowledge can identify IgAVN patients at a greater risk for adverse outcome and increase the evidence for treatment recommendations.展开更多
Objective: To investigate the effects of tripterygium wilfordii combined with Salvia Miltiorrhiza therapy on renal function, coagulation function and immune response in children with purpura nephritis. Methods: A tota...Objective: To investigate the effects of tripterygium wilfordii combined with Salvia Miltiorrhiza therapy on renal function, coagulation function and immune response in children with purpura nephritis. Methods: A total of 70 children with purpura nephritis who were treated in the hospital between October 2013 and March 2017 were divided into control group (n=35) and Salvia Miltiorrhiza group (n=35) by random number table. Control group received routine + tripterygium wilfordii therapy, Salvia Miltiorrhiza group received routine+ tripterygium wilfordii + Salvia Miltiorrhiza therapy, and the therapies lasted for 3 courses. The differences in renal function, coagulation function and immune response were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in renal function, coagulation function and immune response function between the two groups. After 3 courses of treatment, renal function indexes CysC,β2MG and 24 h UmAlb levels in Salvia Miltiorrhiza group were lower than those in control group;coagulation function indexes FIB and D-D levels in peripheral blood were lower than those of control group;immune response indexes Th1 cytokines IL-2 and IFN-γ contents in peripheral blood were higher than those of control group whereas Th2 cytokines IL-5 and IL-10 contents were lower than those of control group. Conclusion: Tripterygium wilfordii combined with Salvia Miltiorrhiza therapy can effectively optimize the renal function, reduce the hypercoagulation state and reduce the Th1/Th2 immune imbalance in children with purpura nephritis.展开更多
Objective:To study the effect of Helicobacter pylori infection on renal function and immune response in children with Henoch-Sch?oenlein purpura (HSP).Methods: Children diagnosed with Henoch-Sch?oenlein purpura in Zho...Objective:To study the effect of Helicobacter pylori infection on renal function and immune response in children with Henoch-Sch?oenlein purpura (HSP).Methods: Children diagnosed with Henoch-Sch?oenlein purpura in Zhognshan Chenxinghai Hospital and Huizhou Third People's Hospital between May 2013 and July 2016 were selected and divided into Hp(﹢) and Hp(-) HSP group according to Helicobacter pylori infection condition. Then renal function and immune response were determined.Results: Scr, BUN, CysC, TM, vWF, sVCAM-1, CTGF, MMP9, IL-17 and IL-23 contents in serum as well as Th17 cell content in peripheral blood of Hp(﹢) HSP group were significantly higher than those of Hp(-) HSP group, Treg cell content in peripheral blood as well as TGF-β1 and IL-10 contents in serum of Hp(﹢) HSP group were significantly lower than those of Hp(-) HSP group, SOCS1 and Tim1 mRNA expression in peripheral blood mononuclear cells of Hp(﹢) HSP group were significantly higher than those of Hp(-) HSP group, and SOCS3 and Tim3 mRNA expression were not significantly different from those of Hp(-) HSP group.Conclusion:Helicobacter pylori infection in children with Henoch-Sch?oenlein purpura can aggravate the damage of renal function and the disorder of autoimmune response.展开更多
目的 探讨紫癜性肾炎(HSPN)患儿PLT、血小板压积(PCT)等血小板参数与肾脏病理分级及肾功能的关系。方法 回顾性分析2022年1月至2023年3月河南中医药大学第一附属医院收治的46例过敏性紫癜(HSP)和89例HSPN患儿的临床资料,比较两组患儿血...目的 探讨紫癜性肾炎(HSPN)患儿PLT、血小板压积(PCT)等血小板参数与肾脏病理分级及肾功能的关系。方法 回顾性分析2022年1月至2023年3月河南中医药大学第一附属医院收治的46例过敏性紫癜(HSP)和89例HSPN患儿的临床资料,比较两组患儿血小板参数、凝血功能、肾功能水平。HSPN患儿根据肾脏病理结果分为Ⅱ型28例、Ⅲa型32例、Ⅲb及以上29例,比较不同肾脏病理分型HSPN患儿血小板参数、凝血功能、肾功能水平、24 h尿蛋白含量(24 h UP);采用Pearson相关分析血小板参数与凝血功能、肾功能水平的关系。采用ROC曲线评价血小板参数对HSPN患儿肾功能障碍的诊断效能。结果 HSPN组PLT、PCT、尿素氮(BUN)、血肌酐(Scr)、TT水平均高于HSP组,APTT水平低于HSP组(均P<0.05)。随着肾脏病理分型的升高,PLT、PCT、BUN、24 h UP水平逐渐上升,3组间差异有统计学意义(均P<0.05)。Pearson相关分析显示,HSPN患儿PLT、PCT水平与BUN、Scr、24 h UP均呈正相关(均P<0.05)。ROC曲线分析表明,PLT、PCT两者联合诊断HSPN患儿发生肾功能障碍的AUC为0.880,高于单一指标诊断(均P<0.05),灵敏度为0.727,特异度为0.978。结论 不同肾脏病理分型HSPN患儿PLT、PCT水平存在显著差异,与肾功能指标呈显著正相关。检测HSPN患儿PLT、PCT水平有助于评估其肾脏病理分型和肾功能障碍发生情况。展开更多
文摘Summary： In order to characterize their relationship through clinicopathological comparison between IgA nephropathy and Henoch-Schoenlein purpura nephritis （HSPN）, 31 children with IgA nephrop- athy aged between 3 to 15 years and 120 children with HSPN aged between 4 to 15 years were compared with each other in clinical manifestation, blood biochemistry, serum immunology and followup study. Renal pathological findings under light microscope, immunofluorescence and electronic microscope were analyzed and also compared between 31 children with IgA nephropathy and 32 biopsied children with HSPN. The results showed that the onset age was over 12 years in 25.8 % children with IgA nephropathy, but only 10 % in HSPN （P〈0.05）. The clinical patterns of IgA nephropathy and HSPN were similar, but extra-renal manifestations were more often in HSPN, all of them had skin purpura, 59 % had gastrointestinal symptoms and 47 % suffered from arthralgia, compared with only abdominal pain in 3.2 % children with IgA nephropathy. The renal pathological investigation showed global sclerosis in 35.5 % of IgA nephropathy and 3.1% of HSPN, mesangial sclerosis in 41.9 % of IgA nephropathy and 6.3 % of HSPN, but endothelial proliferation in 65.6 % of HSPN and 29 % of IgA nephropathy （all P〈0.01）. Thin basement membrane nephropathy was only found in 6. 5 % children with IgA nephropathy, no in HSPN. The electronic dense deposits in HSPN were sparse, lodse and wildly spread in glomerular mesangium, subendothelial area and even intra basement membrane, but it was dense, lumpy and mostly limited in mesangium and paramesangium in IgA nephropathy. Predominant IgA deposits were found in 81.2% of HSPN, and overwhelming IgG deposits in 12.5 % of HSPN with relatively weak IgA deposits, moreover 6.3 % of HSPN showed linear IgG deposits in glomerular capillary. Totally 71. 9 G of HSPN had IgG deposits in glomeruli and only 19.4% of IgA nephropathy showed glomerular IgG deposits （P〈0. 01）. No IgG deposit was observed in 81. 6 % of IgA nephropathy, among them most showed IgA and IgM and/or C3 deposits, moreover overwhelming IgG deposits and linear IgG deposits couldn＇t be found in IgA nephropathy. Mean 20 months follow-up showed complete remission in 72.5% of HSPN, but only 19.4% in IgA nephropathy after 34 months follow-up. Moreover, 64.5 % of IgA nephropathy had consistent hematuria and proteinuria and 16. 1% had active nephritides （P〈0.05）. It was concluded that significant clinico-pathological difference was found between HSPN and IgA nephropathy, which didn＇t support the one disease entity hypothesis. HSPN and IgA nephropathy are probably two diseases with similar immune abnormalities.
文摘BACKGROUND The incidence of pulmonary embolism(PE) in children is low, but its mortality is high. Hypereosinophilic syndrome(HES) is a group of diseases caused by an abnormal increase in eosinophilic granulocytes resulting in multiple-organ dysfunction. The urgent event of thromboembolism in the pulmonary region provoked by eosinophils in idiopathic HES(IHES) is relatively unusual. This article reports a case of IHES with multiple PEs and left leg venous thrombosis as the first manifestation. One month later, the patient developed Henoch-Schonlein purpura(HSP), which is very rare.CASE SUMMARY We report the case of a 12-year-old boy who was admitted to the hospital with dyspnea, left leg pain, and aggravation. He had bilateral PE and left leg venous embolism with mild eosinophilia. Low-molecular-weight heparin and urokinase were given. At the same time, the interventional department was contacted about filter implantation, followed by urokinase thrombolysis. The left leg thrombus was aspirated under ultrasound guidance. He was discharged from the hospital on rivaroxaban. One month later, he developed a rash on both legs and ankle pain consistent with HSP, with severe eosinophilia and motor and sensory disturbances. The patient was diagnosed with IHES with multiple embolisms complicated by HSP after excluding other causes of the eosinophil elevation. After glucocorticoid treatment, the symptoms were relieved, but the patient later developed purpura nephritis.CONCLUSION We report a rare and life-threatening case of IHES with multiple embolisms associated with HSP.A mild elevation of eosinophils early in the disease leads to difficulties in diagnosis and delayed treatment.
文摘BACKGROUND Purpura nephritis,also called Henoch-Schönlein purpura nephritis,is a systemic disease with small dead vasculitis as the main pathological change.AIM To observe the influence of transitional nursing activities on the compliance behaviors and disease knowledge of children with purpura nephritis.METHODS A total of 82 children with purpura nephritis were included and divided into a general nursing group(41 children)and transitional nursing group(41 children)using the envelope method.The general nursing group received routine nursing care,while the transitional nursing group received transitional nursing care.The behaviors,knowledge of the disease,and self-management ability of the two groups were evaluated after nursing care was provided.RESULTS The scores of four items(self-care ability,self-responsibility,health knowledge level,and self-concept)in the transitional nursing group were significantly higher than those in the general nursing group.CONCLUSION Transitional nursing can directly improve the disease knowledge level and selfmanagement ability of children with purpura nephritis and effectively reduce complications.
文摘The clinical spectrum of immunoglobulin A vasculitis nephritis(IgAVN)ranges from the relatively common transitory microscopic hematuria and/or low-grade proteinuria to nephritic or nephrotic syndrome,rapidly progressive glomerulonephritis,or even renal failure.Clinical and experimental studies have shown a multifactor pathogenesis:Infection triggers,impaired glycosylation of IgA1,complement activation,Toll-like-receptor activation and B cell proliferation.This knowledge can identify IgAVN patients at a greater risk for adverse outcome and increase the evidence for treatment recommendations.
文摘Objective: To investigate the effects of tripterygium wilfordii combined with Salvia Miltiorrhiza therapy on renal function, coagulation function and immune response in children with purpura nephritis. Methods: A total of 70 children with purpura nephritis who were treated in the hospital between October 2013 and March 2017 were divided into control group (n=35) and Salvia Miltiorrhiza group (n=35) by random number table. Control group received routine + tripterygium wilfordii therapy, Salvia Miltiorrhiza group received routine+ tripterygium wilfordii + Salvia Miltiorrhiza therapy, and the therapies lasted for 3 courses. The differences in renal function, coagulation function and immune response were compared between the two groups before and after treatment. Results: Before treatment, there was no statistically significant difference in renal function, coagulation function and immune response function between the two groups. After 3 courses of treatment, renal function indexes CysC,β2MG and 24 h UmAlb levels in Salvia Miltiorrhiza group were lower than those in control group;coagulation function indexes FIB and D-D levels in peripheral blood were lower than those of control group;immune response indexes Th1 cytokines IL-2 and IFN-γ contents in peripheral blood were higher than those of control group whereas Th2 cytokines IL-5 and IL-10 contents were lower than those of control group. Conclusion: Tripterygium wilfordii combined with Salvia Miltiorrhiza therapy can effectively optimize the renal function, reduce the hypercoagulation state and reduce the Th1/Th2 immune imbalance in children with purpura nephritis.
基金Zhongshan Science and Technology Plan Project No:20122A065
文摘Objective:To study the effect of Helicobacter pylori infection on renal function and immune response in children with Henoch-Sch?oenlein purpura (HSP).Methods: Children diagnosed with Henoch-Sch?oenlein purpura in Zhognshan Chenxinghai Hospital and Huizhou Third People's Hospital between May 2013 and July 2016 were selected and divided into Hp(﹢) and Hp(-) HSP group according to Helicobacter pylori infection condition. Then renal function and immune response were determined.Results: Scr, BUN, CysC, TM, vWF, sVCAM-1, CTGF, MMP9, IL-17 and IL-23 contents in serum as well as Th17 cell content in peripheral blood of Hp(﹢) HSP group were significantly higher than those of Hp(-) HSP group, Treg cell content in peripheral blood as well as TGF-β1 and IL-10 contents in serum of Hp(﹢) HSP group were significantly lower than those of Hp(-) HSP group, SOCS1 and Tim1 mRNA expression in peripheral blood mononuclear cells of Hp(﹢) HSP group were significantly higher than those of Hp(-) HSP group, and SOCS3 and Tim3 mRNA expression were not significantly different from those of Hp(-) HSP group.Conclusion:Helicobacter pylori infection in children with Henoch-Sch?oenlein purpura can aggravate the damage of renal function and the disorder of autoimmune response.
文摘目的 探讨紫癜性肾炎(HSPN)患儿PLT、血小板压积(PCT)等血小板参数与肾脏病理分级及肾功能的关系。方法 回顾性分析2022年1月至2023年3月河南中医药大学第一附属医院收治的46例过敏性紫癜(HSP)和89例HSPN患儿的临床资料,比较两组患儿血小板参数、凝血功能、肾功能水平。HSPN患儿根据肾脏病理结果分为Ⅱ型28例、Ⅲa型32例、Ⅲb及以上29例,比较不同肾脏病理分型HSPN患儿血小板参数、凝血功能、肾功能水平、24 h尿蛋白含量(24 h UP);采用Pearson相关分析血小板参数与凝血功能、肾功能水平的关系。采用ROC曲线评价血小板参数对HSPN患儿肾功能障碍的诊断效能。结果 HSPN组PLT、PCT、尿素氮(BUN)、血肌酐(Scr)、TT水平均高于HSP组,APTT水平低于HSP组(均P<0.05)。随着肾脏病理分型的升高,PLT、PCT、BUN、24 h UP水平逐渐上升,3组间差异有统计学意义(均P<0.05)。Pearson相关分析显示,HSPN患儿PLT、PCT水平与BUN、Scr、24 h UP均呈正相关(均P<0.05)。ROC曲线分析表明,PLT、PCT两者联合诊断HSPN患儿发生肾功能障碍的AUC为0.880,高于单一指标诊断(均P<0.05),灵敏度为0.727,特异度为0.978。结论 不同肾脏病理分型HSPN患儿PLT、PCT水平存在显著差异,与肾功能指标呈显著正相关。检测HSPN患儿PLT、PCT水平有助于评估其肾脏病理分型和肾功能障碍发生情况。
