A Study Of The Relationship Between Childhood Primary Steroid Sensitive Nephrotic Syndrome And Atpoic Diseases

Objective : To investigate the relationship between steroid-sensitive nephrotic syndrome(SSNS)and atopic disease in children,in which total IgE,histamine and bradykinin change with first attract,recurrence and remission,to provide new clues and basis for disease treatment.Methods:234 pediatric patients,diagnosed as primary nephrotic syndrome admitted to the Department of Pediatric Nephrology of Shengjing Hospital,China Medical University from January 1st 2018 to December 31 st 2019 were selected for clinical data and laboratory results including(age,gender,total IgE,24 h urinary protein,blood biochemistry,blood routine,cytokines)and followed up.The incidence of comorbidities with allergic diseases,recurrence season and associated symptoms were analyzed.Serum samples were collected from children with recurrent SSNS at the initial stage,remission stage and recurrence stage.The levels of histamine and bradykinin in serum were determined by enzyme-linked immunosorbent assay.Results:For 234 children with nephrotic syndrome,67 cases(28.63%)had respiratory tract allergy and 76 cases(32.48%)had skin allergy as IL-2,IL-4,IL-10 and TNF-а were significantly increased(P<0.05).For recurrent groups,children with allergy was significantly more than with infection(P<0.001).as the recurrence rate in spring and autumn was higher,which was consistent with the high incidence season of allergy(P<0.05).For the serum total IgE,the levels in the initial group(688.38±815.90 IU/ml)and the recurrent group(699.71±894.27 IU/ml)were significantly higher than those in the remission group(250.27±411.15IU/ml)(P<0.05).For serum bradykinin,the levels of initial group(1234,21±1247.31 ng/ml)and recurrent group(973.95±469.9ng/ml)were significantly higher than those of remission group(595.69±387.47ng/ml)(P<0.05).For serum histamine,the levels of initial group(28.61±28.79 ng / ml)were significantly higher than those of remission group(P<0.05),while remission group and recurrent group were close to the normal range.Conclusions:The serum IgE of mostly nephrotic syndrome patients was significantly increased which related with atopic diseases as the high comorbidity of skin allergy and airway allergy.The predisposing factors of nephrotic syndrome recurrence were mostly related to allergy and infection.The levels of total IgE and bradykinin in the primary and recurrent nephrotic syndrome group were significantly higher than those in the remission group,while the level of serum histamine was only increased in the primary nephrotic syndrome group.It was suggested that IgE,histamine and bradykinin may be involved in the occurrence and recurrence of nephrotic syndrome in children which required further mechanism research to provide new clues and new schemes for the treatment of SSNS in children.