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KMID : 1038820150180010039
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Pediatric Gastroenterology, Hepatology & Nutrition
2015 Volume.18 No. 1 p.39 ~ p.47
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Laboratory Markers Indicating Gastrointestinal Involvement of Henoch-Schonlein Purpura in Children
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Hong Jeana
Yang Hye-Ran
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Abstract
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Purpose: To determine clinically useful biochemical markers reflecting disease activity and/or gastrointestinal (GI)tract involvement in Henoch-Schonlein purpura (HSP).
Methods: A total of 185 children with HSP and 130 controls were included. Laboratory data indicating inflammation,standard coagulation, and activated coagulation were analyzed for the HSP patients, including measurements ofthe hemoglobin level, white blood cell (WBC) count, absolute neutrophil count (ANC), platelet count, erythrocytesedimentation rate (ESR), C-reactive protein (CRP) level, prothrombin time, activated partial thromboplastin time,and fibrinogen, D-dimer, and fibrin degradation product (FDP) levels. The clinical scores of the skin, joints, abdomen,and kidneys were assessed during the acute and convalescence phases of HSP.
Results: The WBC count, ANC, ESR, and CRP, fibrinogen, D-dimer, and FDP levels were significantly higher inthe acute phase compared with the convalescent phase of HSP (p<0.05). The total clinical scores were more stronglycorrelated with the D-dimer (r=0.371, p<0.001) and FDP (r=0.369, p<0.001) levels than with inflammatory markers,such as the WBC count (r=0.241, p=0.001), ANC (r=0.261, p<0.001), and CRP (r=0.260, p<0.001) levels. The patientswith GI symptoms had significantly higher ANC (median [interquartile range], 7,138.0 [4,446.4-9,470.0] vs.5,534.1 [3,263.0-8,153.5], p<0.05) and CRP (0.49 [0.15-1.38] vs. 0.23 [0.01-0.67], p<0.05), D-dimer (2.63 [1.20-4.09]vs. 1.75 [0.62-3.39]), and FDP (7.10 [0.01-13.65] vs. 0.10 [0.01-7.90], p<0.05) levels than those without GI symptoms.
Conclusion: D-dimer and FDPs are more strongly associated with disease activity and more consistently reflect GIinvolvement than inflammatory markers during the acute phase of HSP.
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KEYWORD
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Purpura, Schonlein-Henoch, Blood coagulation, Inflammation, Fibrin fibrinogen degradation products, Fibrin fragment D, Child
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