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QJM Advance Access originally published online on September 6, 2006
QJM 2006 99(11):801; doi:10.1093/qjmed/hcl093
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© The Author 2006. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Correspondence

Prognostic serological markers of Henoch-Schönlein nephritis

Sir,

We read with interest the article on Henoch-Schönlein purpura with nephritis in adults by Shrestha et al.1 They point out that there have been no serological markers of prognosis in Henoch-Schönlein nephritis (HSN) in both children and adults. However, a previous report of ours suggested that the serum IgA/C3 ratio could be a useful marker of disease activity in children with severe HSN.2 In this study, the levels of serum IgA or C3 at presentation were variable, but serial assessment of the serum IgA/C3 ratio ({triangleup}IgA/C3) showed a significant correlation with changes in severity of renal pathology and clinical outcome. High circulating levels of IgA did not always correlate with an increase of polymeric IgA1 and mesangial deposition, and levels of serum C3 are not generally decreased in HSN. However, the direction of the changes of IgA and C3 was important, and correlated with clinical outcome. Therefore, IgA and C3 may be an important factor in understanding the pathogenesis of HSN, and the measurement of serum IgA/C3 ratio may be a useful marker of renal progression in HSN patients. However, a large prospective study may be needed to elucidate whether serum IgA/C3 ratio predicts long-term prognosis in children and adults with HSN.

J.I. Shin and J.S. Lee

Institute of Kidney Disease
Department of Pediatrics
Yonsei University College of Medicine
Seoul
Korea

email: jsyonse{at}yumc.yonsei.ac.kr

References

1. Shrestha S, Sumingan N, Tan J, Althous H, McWilliam L, Ballardie F. Henoch-Schönlein purpura with nephritis in adults: adverse prognostic indicators in a UK population. Q J Med 2006; 99:253–65.

2. Shin JI, Park JM, Shin YH, Lee JS, Jeong HJ, Kim HS. Serum IgA/C3 ratio may be a useful marker of disease activity in severe Henoch-Schönlein nephritis. Nephron Clin Pract 2005; 101:c72–8.[CrossRef][ISI][Medline]


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This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
99/11/801    most recent
hcl093v1
Right arrow Alert me when this article is cited
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Right arrow Articles by Shin, J.I.
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PubMed
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Right arrow Articles by Shin, J.I.
Right arrow Articles by Lee, J.S.
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