Clinical and pathological features of children with immunoglobulin A vasculitis with nephritis accompanied by different proportions of crescent formation.
10.7499/j.issn.1008-8830.2407060
- Author:
Meng-Ke BAI
1
;
Long WANG
1
;
Hang LI
;
Hang SU
1
;
Yue-Li YANG
1
;
Xiao-Qing YANG
1
Author Information
1. Department of Pediatrics, First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, China.
- Publication Type:Journal Article
- Keywords:
Child;
Clinical manifestation;
Crescent;
Immunoglobulin A vasculitis with nephritis;
Pathological feature
- MeSH:
Humans;
Male;
Child;
Female;
Child, Preschool;
Adolescent;
Glomerulonephritis, IGA/blood*;
Immunoglobulin G/blood*;
IgA Vasculitis/pathology*
- From:
Chinese Journal of Contemporary Pediatrics
2024;26(12):1329-1334
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVES:To investigate the impact of the different proportions of crescent formation on clinical manifestations and pathological features in children with immunoglobulin A vasculitis with nephritis (IgAVN).
METHODS:The children with IgAVN were divided into no-crescent group (75 children), ≤25% crescent group (156 children), and >25% crescent group (33 children).
RESULTS:Compared with the no-crescent group, the other two groups had significant increases in 24-hour urinary protein, urinary immunoglobulin G (IgG)/creatinine ratio, urine red blood cell count, fibrinogen, and neutrophil-lymphocyte ratio, a significant reduction in serum IgG, and a significantly higher proportion of children with low albumin and hypercoagulability, pathological grade III+IV or diffuse mesangial proliferation (P<0.05). Compared with the ≤25% crescent group, the >25% crescent group had significant increases in 24-hour urinary protein, urine red blood cell count, and fibrinogen, significant reductions in serum IgG and glomerular filtration rate, and a significantly higher proportion of children with diffuse mesangial proliferation, tubular atrophy or interstitial fibrosis (P<0.05). Compared with the no-crescent group, the >25% crescent group had significantly higher levels of total cholesterol, triglycerides, urea nitrogen, and serum creatinine (P<0.05). A reduction in serum IgG, hypercoagulability, an increase in 24-hour urinary protein, diffuse mesangial proliferation, and chronic tubulointerstitial lesions were influencing factors for the increase in the proportion of crescent formation (P<0.05).
CONCLUSIONS:For children with IgAVN, the higher proportion of crescent formation is associated with greater abnormalities in laboratory markers and more severe chronic tubulointerstitial lesions, and thus a detailed analysis of the proportion of crescent formation can better guide clinical treatment.
