engleski

New candidate biomarker of nephritis risk assessment in children with Henoch-Schönlein purpura

Goal: Henoch-Schönlein purpura (HSP) is the most common vasculitis of the childhood. Among all possible symptoms/complications, nephritis (HSPN) is the main and almost only cause of morbidity and mortality in HSP. The aim of the study was to investigate the value of erythrocyte glutathione S-transferase (e-GST) activity as an early predictor of HSPN. Methods: Ninety-seven children with HSP were enrolled into the study. The control group consisted of 52 children without clinical and laboratory signs of inflammation. In all participants e-GST activity was determined spectrometrically from the whole blood samples, after incubation with a commercial GST assay. Results: At the beginning of the disease the e-GST activity was significantly higher in HSPN patients who developed the nephritis during the six month follow up period, compared to the group of HSP patients without signs of nephritis: median (interquartile range) 5, 70 U/mgHb (4, 38-7, 50 U/mgHb) compared to 3, 10 U/mgHb (2, 20-4, 20 U/mgHb) ; P<0, 001. Similar results were obtained after the comparison of the HSPN patients and control group: 5, 70 U/mgHb (4, 38-7, 50 U/mgHb) vs.3, 13 U/mgHb (1, 91-4, 20 U/mgHb) ; P<0, 001. There were no statistically significant differences between the group of HSP patients without nephritis and control group (P=0, 837). During the follow up period, a significant decrease of e-GST activity was observed in the HSPN patients, but it was still significantly higher compared to the group of HSP patients without nephritis (P<0, 001/P<0, 001). Conclusion: e-GST activity is a reliable, independent marker of early nephritis risk assessment in children with HSP. As a sensitive, specific and feasible laboratory test, it has potential practical utility in the diagnostic algorithm and monitoring of the children with HSP.

Henoch-Schönlein purpura ; vasculitis ; pediatrics

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