RENAL TUTULUMU OLAN HENOCH-SCHÖNLEİN PURPURALI HASTALARDA ANJİYOTENSİN KONVERTİNG ENZİM GEN POLİMORFİZMİNİN PROGNOZLA İLİŞKİSİ
Abstract
Amaç: Henoch-Schönlein purpurası (HSP) sıklıkla çocukluk çağında görülen, nadiren böbrek yetersizliğine ilerleyebilen bir vaskülittir. Çalışmada renal tutulumu olan HSP’lı hastalarda anjiotensin konverting enzim (ACE) gen polimorfizminin prognozla ilişkisini araştırdık
Materyal ve Metot: HSP nefriti tanısı ile izlenen ACE gen polimorfizmi çalışılmış 0-18 yaş arası 42 hasta çalışmaya alındı. Hastalar delesyon (DD) allelline sahip olanlar (Grup1) ile heterozigot delesyon (ID) veya insersiyon (II) allelline sahip olanlar (grup2) olarak ayrıldı; iki grup tanı yaşları, cinsiyet dağılımı, renal tutulumun ağırlık derecesi açısından karşılaştırıldı.
Bulgular: Grup 1’de (DD) 15 erkek 14 kız toplam 29 hasta vardı, ortalama yaşları 8,26±3 yıl, izlem süreleri 3,34±2,1 yıldı. Grup 2’de (ID/II) 6 erkek 7 kız toplam 13 hasta vardı, ortalama yaşları 7,92±3,1 yıl, izlem süreleri 2,1±1,9 yıl idi. İki grup arasında cinsiyet dağılımı, yaş ve izlem süreleri bakımından istatiksel bir fark görülmedi. Grup 1’de 11 hastada hafif, 14 hastada orta, 4 hastada ciddi renal tutulum gözlendi. Grup 2’de 4 hastada hafif, 8 hastada orta, 1 hastada ciddi renal tutulum gözlendi. Renal tutulumun ağırlığı açısından gruplar arasında istatiksel olarak anlamlı bir fark görülmedi. Proteinüri düzelme oranı grup1’de (DD), grup2’den (ID,II) daha düşüktü, sırası ile (%31,2), (%62,5), ancak vaka sayıları az olduğundan istatiksel olarak anlamlı bulunmadı [ID veya II/ID (OR):3,667, (%95 Cl 0,619- 21,739)].
Sonuç: Renal tutulumu olan HSP’li çocuklarda böbrek tutulumunun ağırlığı ile DD genotipi veya D allelli arasında anlamlı bir ilişki görülmedi, ancak daha geniş ölçekli çalışmalarla desteklenmesi gereklidir.
Keywords
Supporting Institution
YOK
References
- 1. Jauhola O, Ronkainen J, Koskimies O, Ala-Houhla M, Arikoski P, HölttaT, et al. Renal manifestations of Henoch-Schonlein purpura in a 6-month prospective study of 223 children. Arch Dis Child. 2010; 95:877.
- 2. 2.Chang WL, Yang YH, Wang LC, Lin YT, Chiang BL. Renal manifestations in Henoch-Schönlein purpura: a 10-year clinical study. Pediatr Nephrol. 2005; 20:1269.
- 3. Zee RY, Lou YK, Griffiths LR, Morris BJ. Association of a polymorphism of the angiotensin I-converting enzyme gene with essential hypertension. Biochem Biophys Res 184:9-15.
- 4. Haszon I, Friedman AL, Papp F, Bereczki C, Baji S, Bodrogi T. ACE gene polymorphism and renal scarring in primary vesicoureteric reflux. Pediatr Nephrol 2002; 17:1027-31.
- 5. Zhou TB, Yin SS, Liang R. A meta-analysis of the association between angiotensin-converting enzyme insertion/deletion gene polymorphism and end-stage renal disease risk in IgA nephropathy patients. J Renin Angiotensin Aldosterone Syst. 2013; 14: 235-41.
- 6. Mills JA, Michel BA, Block D. The Americal College of Rheumatology 1990 criteria for the classification of Henoch- Schonlein Purpura. Arthritis Rheum 1990; 33:1114-21.
- 7. Hatemi AC, Cine N, Özcelik T. Allele and genotype frequencies of the angiotension converting enzyme (ACE) gene insertion /deletion polymorphism in the turkish population. Tr J Med Sci 1997; 27: 205-8.
- 8. Berdeli A, Cam FS. Prevalence of the angiotensin I converting enzyme gene insertion/deletion polymorphism in a healthy Turkish population. Biochem Genet 2009; 47: 412-20.
- 9. Li H, Zhao D, Yang Q. Meta-analysis of the association between angiotension-converting enzyme I/D polymorphism and susceptibility to children with Henoch-Schönlein purpura or Henoch-Schölein purpura nephritis]. Zhonghua Yi Xue Za Zhi. 2014 8; 94:2039-44.
- 10. H Dursun, A Noyan, A Karabay Bayazıd, Matyar S, Büyükçelik M, Şimşek B. ve ark. Henoch-Schonlein purpuralı çocuklarda angiotensin konverting enzim gen polimorfizmi. Çocuk Dergisi 2013; 13: 11-15.
- 11. Yoshioka T, Xu YX, Yoshida H, Shiraga H, Muraki T, Ito K. Deletion polymorphism of the angiotensin converting enzyme gene predicts persistent proteinuria in Henoch-Schönlein purpura nephritis. Arch Dis Child 1998; 79: 394-9.
THE ASSOCİATİON OF ANGİOTENSİON CONVERTİNG ENZYME GENE POLİMORPHİSM WİTH PROGNOSİS OF HENOCH-SHONLEİN PURPURA WİTH RENAL İNVOLVEMENT İN THE CHİLDREN
Abstract
Objective: Henoch-Schönlein purpura (HSP) is a vasculitis rarely progresses to renal failure. In this study, we investigated association between angiotensin converting enzyme (ACE) gene polymorphism and prognosis of HSP nephritis.
Materials and Methods: Forty-two patients with HSP nephritis and ACE gene polymorphism studied were included in the study. Those who have deletion (DD) allele and heterozygous deletion (ID) or insertion (II) allele classified into 2 groups, then compared according to age of diagnosis, gender distribution, severity of renal involvement.
Results: In Group-1 (DD), of the 29 patients, 15 boys and 14 girls, their mean age was 8.26 ± 3 years, follow-up time was 3.34 ± 2.1 years. In group-2 (ID / II) of the 13 patients 6 boys and 7 girls, their mean age was 7.92 ± 3.1 years, follow-up time was 2.1 ± 1.9 years. In group-1, renal involvement was mild in 11, moderate in 14, and severe in 4 patients. In group-2 4 patients had mild, 8 patients had moderate and 1 patient had severe renal involvement. There was no statistically significant difference in severity of renal involvement between two groups. Although there was a difference in proteinuria recovery rates between the two groups, the number of cases was not enough for statistical analysis [ID or II / ID (OR): 3,667, (95% Cl 0.619-21.739).
Conclusion: There was no significant association between the severity of renal involvement of HSP with DD genotype or D allele, however, this needs to be supported by studies with larger series.
Keywords
References
- 1. Jauhola O, Ronkainen J, Koskimies O, Ala-Houhla M, Arikoski P, HölttaT, et al. Renal manifestations of Henoch-Schonlein purpura in a 6-month prospective study of 223 children. Arch Dis Child. 2010; 95:877.
- 2. 2.Chang WL, Yang YH, Wang LC, Lin YT, Chiang BL. Renal manifestations in Henoch-Schönlein purpura: a 10-year clinical study. Pediatr Nephrol. 2005; 20:1269.
- 3. Zee RY, Lou YK, Griffiths LR, Morris BJ. Association of a polymorphism of the angiotensin I-converting enzyme gene with essential hypertension. Biochem Biophys Res 184:9-15.
- 4. Haszon I, Friedman AL, Papp F, Bereczki C, Baji S, Bodrogi T. ACE gene polymorphism and renal scarring in primary vesicoureteric reflux. Pediatr Nephrol 2002; 17:1027-31.
- 5. Zhou TB, Yin SS, Liang R. A meta-analysis of the association between angiotensin-converting enzyme insertion/deletion gene polymorphism and end-stage renal disease risk in IgA nephropathy patients. J Renin Angiotensin Aldosterone Syst. 2013; 14: 235-41.
- 6. Mills JA, Michel BA, Block D. The Americal College of Rheumatology 1990 criteria for the classification of Henoch- Schonlein Purpura. Arthritis Rheum 1990; 33:1114-21.
- 7. Hatemi AC, Cine N, Özcelik T. Allele and genotype frequencies of the angiotension converting enzyme (ACE) gene insertion /deletion polymorphism in the turkish population. Tr J Med Sci 1997; 27: 205-8.
- 8. Berdeli A, Cam FS. Prevalence of the angiotensin I converting enzyme gene insertion/deletion polymorphism in a healthy Turkish population. Biochem Genet 2009; 47: 412-20.
- 9. Li H, Zhao D, Yang Q. Meta-analysis of the association between angiotension-converting enzyme I/D polymorphism and susceptibility to children with Henoch-Schönlein purpura or Henoch-Schölein purpura nephritis]. Zhonghua Yi Xue Za Zhi. 2014 8; 94:2039-44.
- 10. H Dursun, A Noyan, A Karabay Bayazıd, Matyar S, Büyükçelik M, Şimşek B. ve ark. Henoch-Schonlein purpuralı çocuklarda angiotensin konverting enzim gen polimorfizmi. Çocuk Dergisi 2013; 13: 11-15.
- 11. Yoshioka T, Xu YX, Yoshida H, Shiraga H, Muraki T, Ito K. Deletion polymorphism of the angiotensin converting enzyme gene predicts persistent proteinuria in Henoch-Schönlein purpura nephritis. Arch Dis Child 1998; 79: 394-9.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Orginal Article |
| Authors | |
| Publication Date | August 23, 2020 |
| Published in Issue | Year 2020 Volume: 8 Issue: 2 |