Possible pathogenic role of IgE in Henoch-Schönlein purpura.
The incidences of clinical and biological markers of atopy were investigated in 16 children with IgA nephropathy (IgAN) (group A) and in 22 with Henoch-Schönlein purpura nephritis (HSPN) (group B). The incidence of increased plasma IgE levels according to age-matched normal values was significantly higher in group B (17/22, 77%) than in group A (7/16, 44%) (P < 0.05). Although not significant, the incidences of positive RAST tests and of a history of typical atopic symptoms were also higher in group B [10/22 (45%) and 11/22 (50%), respectively] than in group A [4/16 (25%) and 5/16 (31%), respectively]. Moreover, IgE deposits were demonstrated by a peroxidase/anti-peroxidase method on cutaneous Langerhans and mast cells in 4 of 6 patients with HSPN. Thus immunoallergy might account, in some cases, for the cutaneous, intestinal and pulmonary signs observed in HSPN, but not in IgAN. We postulate stimulation of IgE-sensitized mast cells by specific antigens in the presence of IgA circulating immune complexes (CIC), release of vasoactive substances, increased capillary permeability and perivascular deposition of IgA CIC.
Davin
J C
JC
Paediatric Nephrology Unit, State University of Liège, Belgium.
Pierard
G
G
Dechenne
C
C
Grossman
D
D
Nagy
J
J
Quacoe
M
M
Malaise
M
M
Hall
M
M
Jansen
F
F
Chantraine
J M
JM
D000293:Adolescent; D000936:Antigen-Antibody Complex / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D005260:Female; D005922:Glomerulonephritis, IGA / Q000276:immunology; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000276:immunology; D011695:IgA Vasculitis / Q000276:immunology* / Q000473:pathology; D007073:Immunoglobulin E / Q000032:analysis*; D008297:Male; D009393:Nephritis / Q000276:immunology*; D011852:Radioallergosorbent Test; D012867:Skin / Q000276:immunology
D000936:Antigen-Antibody Complex; D007073:Immunoglobulin E