Impaired vascular endothelium-dependent relaxation in Henoch-Schönlein purpura.
Few reports have focused on vascular endothelial function in children with Henoch-Schönlein purpura (HSP). The purpose of the present study was to assess endothelial function and to follow serial changes from the acute to convalescent phases in children with HSP. Forearm flow-mediated vasodilation was evaluated in 21 patients with HSP, aged 4.0-10.3 years (median 6.2 years), and in 14 control subjects. Vascular dimension, mean velocity, and flow volume were measured by ultrasonography in brachial artery before and after hyperemia, and during incremental infusions of nitroglycerin (0.5, 1.0 microg/kg per min). In the controls, significant increases in dimension, mean velocity, and flow volume were observed in reactive hyperemia ( P<0.01). In contrast, patients in the acute phase of HSP showed a flow velocity profile indicating a highly resistant forearm circulation, and significantly attenuated responses after hyperemia ( P<0.01 vs. control), whereas the responses to nitroglycerin were well preserved. In addition, the impaired hyperemic responses recovered in the convalescent phase, with no significant differences compared with controls. These results clearly suggest that forearm vascular endothelium-dependent relaxation was attenuated in patients with acute HSP.
Kurotobi
Shunji
S
Department of Developmental Medicine (Pediatrics), D-5, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita city, 565-0871 Osaka, Japan. kurotobi@ped.med.osaka-u.ac.jp
Kawakami
Nobuhiro
N
Honda
Atsuko
A
Matsuoka
Taro
T
Hara
Tatsuyuki
T
Nagai
Toshisaburo
T
Shimizu
Kazuo
K
Ozono
Keiichi
K
D000208:Acute Disease; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000187:drug effects; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005542:Forearm / Q000098:blood supply; D006801:Humans; D006940:Hyperemia / Q000000981:diagnostic imaging / Q000503:physiopathology; D011695:IgA Vasculitis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005996:Nitroglycerin / Q000008:administration & dosage / Q000494:pharmacology; D012039:Regional Blood Flow; D014463:Ultrasonography; D014655:Vascular Resistance; D014664:Vasodilation
D005996:Nitroglycerin