Study On Anticardiolipin Antibody In Idiopathic Nephrotic Syndrome Of Children

Anticardiolipin antibody(ACA) is a kind of autoimmune antibody correlating with hypercoagulative state. Combination of ACA with it's target antigens such as phospholipids on the surfaces of the endotheliocyte and thrombocytes can damage the balance of normal thrombosis and thrombolysis. When a patient 's ACA test is positive(moderate to high titer ACA) and the clinical manifestation is thrombosis or recurrent abortion or thrombocytopenia, it's called antiphospholipid syndrome(APS). ACA is often found to be positive in autoimmune diseases such as systemic lupus erythematous(SLE) and systemic juvenile idiopathic arthritis(JIA). Some patients will develop APS during the course of disease and make the treatment more difficult. Prognosis of these patients are always bad.Idiopathic nephrotic syndrome(INS) is a common genitourinary disease in children and it's pathogenesis is not very clear. Up to date, most researches support that dysfunction of immune system partly causes the disease. Patients with nephrotic syndrome always have hypercoagulative state, to investigate if ACA is also a causitive component, samples of thirty three patients with INS , 21 patients with acute glomerulonephritis and 15 children of healthy controls were collected for the study. Method: 1ml intravenous blood of each case was taken and serum were separated by centrifugation and stored in -200C. ACA IgM and IgG were detected by ELISA. Results: ACA IgM value of INS was 10.94±4.66 u/ml with the positive rate 54.6%. ACA IgM value of healthy controls is 5.65±2.86 u/ml with the positive rate 6.7%. ACA IgM value of acute glomerulonephritis is 5.52±3.42 u/ml with the positive rate 9.5%. ACA IgM value and positive rate in INS were higher than these of acute glomerulonephritis and healthy controls(P<0.005). Most of ACA IgM positive cases in INSpatients were in acute phase of disease with urine protein +++, whileACA IgM were negative as INS patients were in the remission. ACA IgG were negative in all the cases. Conclusions: ACA IgM might play a role in the pathogenesis of hypercoagulability in INS of children, which implicated that autoimmune responses participating in the pathogenesis. Besides corticosteroid and other immunosupressants, anti-hypercoagulability should be emphasized in the treatment of INS.