Abstract
Objective IgA vasculitis (lgAV) is the most frequent vessel vasculitis in children, and the prognosis is related to the children's age and degree of nephritis. This study is aimed at investigating serum apolipoprotein M (apoM) levels in patients with lgAV patients and at evaluating the association between apoM and disease severity. Methods A total of 109 lgAV patients and 76 age- and sex-matched healthy controls were included. The age and gender of the study participants were matched. ApoM levels were measured by an enzyme-linked immunosorbent assay. Additionally, the serum levels of lipids, apolipoproteins, kidney biochemical profiles, immunoglobulins (IgA, IgG, IgM, and IgE), and the complements (C3 and C4) were assessed using an automatic biochemical analyzer. Results ApoM was increased significantly in lgAV patients compared to healthy controls. ApoM, meanwhile, was lower in patients with nephritis than in those without nephritis. The apoM levels were higher in classes I and II IgA vasculitis nephritis (lgAVN) patients than in classes III and IV. Besides, the apoM serum level < 24.81 mg/L was an independent predictive factor for lgAVN and can be independently associated with the presence of nephritis in lgAV patients. Meanwhile, the serum apoM concentration negatively correlated with the ISKDC grading score in lgAVN patients. Conclusions Serum apoM was elevated in lgAV patients and decreased gradually with the ISKDC grading score. ApoM (OR = 0.32, 95%CI = 0.12‐0.85, p = 0.023) was identified as a protective factor for nephritis in all lgAV patients.
Highlights
IntroductionThe incidence of lgAV has been increasing in recent years, which varies from 10 to 30 cases per 100,000 children younger than 17 years [1, 2]
LgAV is the most common vessel vasculitides in children, which is self-limited
One hundred nine lgAV patients were included in the study, with 63 boys and 43 girls ranging in age from 1 to 15 (9:04 ± 0:71) years
Summary
The incidence of lgAV has been increasing in recent years, which varies from 10 to 30 cases per 100,000 children younger than 17 years [1, 2]. It is characterized clinically by palpable purpura, arthrocele or arthralgia, gastrointestinal symptoms, and renal disease [3]. The nephritis is called IgA vasculitis nephritis (lgAVN), which develops in 30%–50% of patients with lgAV [4]. LgAVN is potentially the most severe complication, and the prognosis is mostly dependent on the severity of nephritis [5, 6]. It was pointed out that 12.8% of lgAVN patients had an unfavourable outcome [4, 7]
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