Immunological Changes And Clinical Significance In Children With Henoch-Schonlein Purpura

Objective:to study the changes of immunoglobulin,complement and lymphocyte subsets in children with Henoch Schonlcin purpura(HSP)during the acute phase,and to explore its mechanism and clinical significance in the pathogenesis of HSP.Methods:The clinical data and laboratory examinations of 591 children who were admitted to the department of rheumatology and immunology of the children's hospital affiliated to Soochow University and diagnosed as allergic purpura during November 2017 to October 2018 were retrospectively analyzed.Analysis:1.591 cases of children with HSP were selected as the observation group,and the healthy children who underwent physical examination in the health care outpatient department of our hospital were selected as the control group.2.591 children with HSP were divided into type A(simple skin type),type B(abdominal type),type C(articular type),type D(renal type)and type E(mixed type)according to their clinical manifestations.3.591 children with HSP were divided into henoch-schonlein Purpura Nephritis(HSPN)group and non-henoch-schonlein Purpura Nephritis(NHSPN)group according to whether there was renal involvement.Will be more than four groups(compare the following indexes:using the method of transmission immune determination of C3 and C4?IgG?IgM?IgA was evaluated by immune turbidimetric method,using flow cytometry instrument analysis technique to detect peripheral blood mononuclear cells of CD23+?CD19+?CD3+?CD4+?CD8+?CD16+56+?CD4+/CD8+lymphocytes subgroup of change,and the application of SPSS 20.0 statistical software for data processing and statistical analysis,P<0.05 was statistically significant.Results:1.Compared with healthy controls,<4 years old,4 to 6 years old,and>6 years old children with HSP peripheral blood content of C3,C4 and IgA,IgG,were significantly increased(P<0.05),4 to 6 years old,and>6 years old children with HSP lymphocyte subgroup percentage of CD4+cells were significantly decreased(P<0.05),<4 years old,4 to 6 years old,and>6 years old children with HSP were CD3+,CD4+cell count decreased(P<0.05),<4 and 4 to 6 years old children with HSP were CD19+cells decreased(P<0.05),The number of CD8+cells decreased in HSP children<4 years old and>6 years old(P<0.05),and the number of CD23+cells decreased in HSP children 4-6 years old and>6 years old(P<0.05).2.There was no significant difference in peripheral blood immunoglobulin and complement between clinical types of HSP children of all(P>0.05),and there was significant difference in the percentage of CD8+cells between abdominal type and articular type of HSP children aged 4-6 years(P<0.05).3.Ages 4-6:compared with the uninfected group,the IgM level in the peripheral blood of children with mycoplasma pneumoniae was significantly increased(P<0.05).Peripheral blood IgG level was significantly increased in children with streptococcus HSP infection(P<0.05).More than 6 years old:compared with the uninfected children with HSP,the content of IgG and IgM in the peripheral blood of children with mycoplasma pneumoniae was significantly increased(P<0.05),and the number of CD16+56+cells was significantly decreased(P<0.05).Peripheral blood IgA?IgG and IgM levels were significantly increased in children with streptococcus HSP infection(P<0.05).Peripheral blood IgG and IgM levels were significantly increased in children with mycoplasma pneumoniae mixed streptococcus infection associated with HSP(P<0.05)4.Compared with children with non-nephritis HSP,there were no significant differences in humoral immunity,lymphocyte subsets and other indicators between the two groups in children with nephritis HSP(P>0.05).Age 4-6:compared with children without HSPN infection,peripheral blood IgA was significantly increased in children with streptococcus infection(P<0.05),and the number of CD23+and CD 19+cells was significantly decreased(P<0.05).Older than 6 years:compared with children without HSPN infection,peripheral blood IgA and IgM were significantly increased in children with mycoplasma pneumoniae infection-related HSPN(P<0.05).Conclusion:1.C3 and C4 in peripheral blood of children with allergic purpura were significantly increased,suggesting abnormal activation of complement in allergic purpura.2.The percentage and number of T lymphocytes such as CD3+?CD4+and CD8+were significantly decreased in children with allergic purpura,while IgA and IgG were significantly increased,suggesting that children with allergic purpura had T lymphocyte and B lymphocyte dysfunction.3.Serum IgA of children with mycoplasma pneumoniae and streptococcal infection related purpura nephritis was significantly higher than that of children without HSPN infection,suggesting that mycoplasma pneumoniae or streptococcal infection may be involved in the occurrence and development of allergic purpura and purpura nephritis.