title: The correlation between cutaneous IgM deposition and renal involvement in adult patients with Henoch-Schönlein purpura.
abstract: BACKGROUND
  Henoch-Schönlein purpura (HSP) is a systemic and immune complex-related leukocytoclastic vasculitis. A positive correlation has been found between IgM deposition along with IgA in skin lesions diagnosed by direct immunofluorescence (DIF) and renal involvement with HSP.
  
  
  OBJECTIVE
  We sought to investigate the relationship between the systemic associations of the disease and the severity of the skin lesions, as well as the immune deposition findings of the lesional skin provided by DIF in patients with HSP.
  
  
  METHODS
  Between 2001 and 2012, 47 patients with HSP were investigated at our dermatology clinic. Epidemiologic data, laboratory findings, localizations of the palpable purpura, existence of bulla or necrosis in the skin lesions, accompanying systemic involvement, and DIF findings of skin biopsy specimens were recorded.
  
  
  RESULTS
  Of the 47 patients 22 were men and 25 were women (age range 16-88 years, mean 42.2). Among all cases with skin involvement, we found 22 (46.8%) articular involvement, 20 (42.6%) renal involvement and 12 (25.5%) gastrointestinal tract involvement. The frequency of bulla and/or necrosis in the skin lesions was significantly high in patients with gastrointestinal and renal involvement (p<0.05). The risk of renal involvement was significantly high in patients whose DIF examination revealed IgM deposition (p<0.05). No association was found between systemic involvement and IgG, complement 3 (C3) and fibrinogen deposition.
  
  
  CONCLUSIONS
  Patients with HSP, having bullous and/or necrotic lesions and whose skin DIF investigations reveal IgM deposition along with IgA, should be surveyed for the risk of renal involvement.
authors: Haseki Training, Research Hospital, Department of Dermatology Adivar Caddesi Aksaray, 34096 Istanbul, Turkey.
authors: Asli Akin
authors: AA
authors: Belli
authors: Kafkas University, Kafkas Medical School, Department of Dermatology.
authors: Emine
authors: E
authors: Dervis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications* / Q000276:immunology*; D007075:Immunoglobulin M / Q000032:analysis / Q000276:immunology*; D007674:Kidney Diseases / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000276:immunology* / Q000473:pathology; D055815:Young Adult
chemical_list: D007075:Immunoglobulin M
keywords: Henoch-Schönlein purpura; IgM; direct immunofluorescence; palpable purpura; renal involvement