The Glomerular IgG Subclasses Distribute And Its Significance In Children With Henoch-sch?nlein Purpura Nephritis

ObjectiveTo investigate the glomerular Ig G subclasses characteristics and its significance of Henoch-Sch?nlein purpura nephritis(HSPN)in children. MethodsEighty-eight children hospitalized with HSPN from Dec.2012 to May.2014 in the First Affiliated Hospital of Zhengzhou University were divided into 2 groups by the detection of Ig G.Clinical manifestations and pathological features were compared between 2 groups.Using the method of immunofluorescence staine kidney frozen section,observe the area of sediment and intensity. Results1. According to renal pathology were divided into two groups, including Ig G(+), 26 cases of group A(30%);Ig G(-),62 cases of group B(70%).The age of onset and gender of the 2 groups had no significant difference(P>0.05).2. Except kidney-related symptoms in children with HSPN, often accompanied by skin purpura, joints, gastrointestinal, infection symptoms.The infection and joint involvement of group A were higher than group B, and the difference was significant(P<0.05). The immune function compared between the two groups, just B lymphocyte ratio difference was significant(p<0.05).3. The majority renal pathological type of two groups were grade Ⅲ(group A 84.6%,group B 80.6%)and grade II(group A 11.5%,group B 12.9%);The pathological grade and tubular injury between the two groups were no significant difference(p>0.05).4. All of renal pathological changes,54.5%(48/88) had co-deposition of immunoglobulins A and M,23.9%(21/88)had co-deposition of immunoglobulins A,G and M.16.0%(14/88)had deposition of immunoglobulins A,5.7%(5/88) had co-deposition of immunoglobulins A and G,immune complex deposition was not correlated with renal pathologic classification(P>0.05).Between the two groups,the positive rate and intensity of immunoglobulins A and M, complement C3 and 4 were no significant difference.(p>0.05)5. The immunofluorescence staining showed that Ig G1 tended to be highly expressed and its intensity was higher than other subclasses in HSPN.The positive rate and intensity of Ig G4 were lower than other subclasses. Conclusions1. The group of Ig G(+),besides typical purpura,often accompanied by joint and symptoms of infection which should be long-time follow-up.2. The immune complex deposition is not correlated with renal pathologic classification(P>0.05)3. By immunofluorescence staining,Ig G1 deposition is priority to Ig G2 and Ig G3, Ig G4 deposition at least. Ig G immune complexes mediated renal damage, Ig G1 may account for a dominant role.