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Journal of the Korean Society of Pediatric Nephrology 2009;13(2): 138-145. doi: https://doi.org/10.3339/jkspn.2009.13.2.138
급성 연쇄상구균 감염후 사구체신염에서 면역학적 지표의 변화
김도희, 이승우, 이경일, 윤유숙, 황자영, 임정우, 고대균, 이준성
1가톨릭대학교 의과대학 소아과학교실
2가톨릭대학교 의과대학 소아과학교실
3가톨릭대학교 의과대학 소아과학교실
4가톨릭대학교 의과대학 소아과학교실
5가톨릭대학교 의과대학 소아과학교실
6가톨릭대학교 의과대학 소아과학교실
7가톨릭대학교 의과대학 소아과학교실
8가톨릭대학교 의과대학 소아과학교실
The Change of Immunologic Parameters in Acute Poststreptococcal Glomerulonephritis
Do-Hee Kim, Seung-Woo Lee, Kyung-Yil Lee, You-Sook Youn, Ja-Young Hwang, Jung-Woo Rhim, Dae-Kyun Koh, Jun-Sung Lee
1Department of Pediatrics, College of Medicine, The Catholic University of Korea
2Department of Pediatrics, College of Medicine, The Catholic University of Korea
3Department of Pediatrics, College of Medicine, The Catholic University of Korea
4Department of Pediatrics, College of Medicine, The Catholic University of Korea
5Department of Pediatrics, College of Medicine, The Catholic University of Korea
6Department of Pediatrics, College of Medicine, The Catholic University of Korea
7Department of Pediatrics, College of Medicine, The Catholic University of Korea
8Department of Pediatrics, College of Medicine, The Catholic University of Korea
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ABSTRACT
Purpose : This study was aimed to evaluate the changes of immunologic parameters during hospitalization, and the relationship between IgG and other laboratory or clinical indices in patients with acute poststreptococcal glomerulonephritis (APSGN).
Methods : We reviewed the medical charts of 36 children with APSGN who showed ASO titer>250 Todd U/L and C3<70 mg/dL. We evaluated the levels of IgG and other laboratory parameters including C3 and ASO at admission and at discharge (14 cases).
Results : The mean age of APSGN patients was $7.5{pm}2.6$ year of age, and male-to-female ratio was 2.3:1. At presentation, hypertension (systolic blood pressure>125 mmHg), gross hematuria, and weight gain were observed in 27.8% (10/36), 80.1% (29/36), and 80% (24/30) of the patients, respectively. The mean IgG level was $1,432{pm}322$ mg/dL ($1,025{pm}234$ mg/dL in control group, P<0.001), and C3 and ASO levels were $26.1{pm}16.1$ mg/dL and $1,068{pm}730$ Todd U, respectively. There were no correlation between IgG level and the levels of any of the parameters analyzed (ASO, C3, BUN, creatinine and white blood cell count), and the severity of the disease assessed by the weight-change during admission. The patients aged<6 years of age (10 cases) had less degree of the weight-change, compared to those of the patients aged>8 years of age (15 cases) (-0.6% vs. -5.7%, P=0.01). The IgG and ASO levels did not change, but C3 (P=0.001) and IgM (P=0.02) levels increased during admission.
Conclusion : Increased IgG and ASO levels in APSGN did not change, but C3 level increased during admission. IgG level was not correlated with other laboratory parameters (ASO and C3) and the severity of the disease. Younger children seem to have less severe clinical course compare to older children. With our hypothetic pathogenesis of APSGN, further studies are needed to resolve the pathogenesis of the disease including the increase of IgG.
Key words: Poststeptococcal glomerulonephritis | IgG | C3 | antistereptolysin O | IgM
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