title: Could serum pentraxin 3 levels and IgM deposition in skin biopsies predict subsequent renal involvement in children with Henoch-Schönlein purpura?
abstract: BACKGROUND
  The aim of this study was to evaluate the potential of serum pentraxin 3 (PTX3) values as an early predictor of subsequent renal involvement in patients with Henoch-Schönlein purpura (HSP) with no abnormalities on urinary examination and in renal function tests at disease onset.
  
  
  METHODS
  This was a prospective cohort study which included 60 pediatric patients with HSP (age range 3-15 years) who were diagnosed between February 2011 and October 2012 and 60 age- and sex-matched healthy controls. The patients were followed up for at least 18 months. Clinical findings were recorded for all patients at first examination, and blood samples for routine laboratory parameters and PTX3 value as well as skin biopsy specimens were obtained from each subject.
  
  
  RESULTS
  Of the 60 patients with HSP, 29 (48.3 %) developed subsequent renal involvement, of whom four underwent kidney biopsy. The mean serum PTX3 level of patients with subsequent renal involvement was significantly higher than those of patients without renal involvement and of the controls (2.20 ± 1.30 vs. 1.36 ± 0.85 and 1.03 ± 0.7 ng/ml, respectively; p = 0.004). Immunofluorescence evaluation of skin biopsy revealed that in addition to immunoglobulin A (IgA) deposition, the IgM deposition was significantly associated with subsequent renal involvement (p = 0.008).
  
  
  CONCLUSIONS
  A high PTX3 level and IgM staining in skin biopsies from HSP patients may be harbingers of subsequent renal involvement.
authors.affiliation: Department of Pediatric Nephrology, Pamukkale University School of Medicine, Denizli, Turkey, selcukyuksel.nephrology@gmail.com.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Yüksel
authors.forename: Murat
authors.initials: M
authors.lastname: Çağlar
authors.forename: Havva
authors.initials: H
authors.lastname: Evrengül
authors.forename: Tülay
authors.initials: T
authors.lastname: Becerir
authors.forename: Emre
authors.initials: E
authors.lastname: Tepeli
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ergin
authors.forename: Esin Avcı
authors.initials: EA
authors.lastname: Çiçek
authors.forename: Hülya
authors.initials: H
authors.lastname: Aybek
authors.forename: Nagihan
authors.initials: N
authors.lastname: Yalçın
authors.forename: Neşe Çallı
authors.initials: NÇ
authors.lastname: Demirkan
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001706:Biopsy; D002097:C-Reactive Protein / Q000032:analysis*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D011695:IgA Vasculitis / Q000097:blood / Q000150:complications / Q000175:diagnosis* / Q000276:immunology; D007075:Immunoglobulin M / Q000032:analysis*; D008297:Male; D009393:Nephritis / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D000683:Serum Amyloid P-Component / Q000032:analysis*; D012867:Skin / Q000276:immunology*; D013997:Time Factors; D015854:Up-Regulation; D000099153:Pentraxins
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D007075:Immunoglobulin M; D000683:Serum Amyloid P-Component; D000099153:Pentraxins