RENAL TUTULUMU OLAN HENOCH-SCHÖNLEİN PURPURALI HASTALARDA ANJİYOTENSİN KONVERTİNG ENZİM GEN POLİMORFİZMİNİN PROGNOZLA İLİŞKİSİ

Year 2020, , 191 - 196, 23.08.2020

Sevliya Öcal Demir

https://doi.org/10.37696/nkmj.695799

Abstract

Amaç: Henoch-Schönlein purpurası (HSP) sıklıkla çocukluk çağında görülen, nadiren böbrek yetersizliğine ilerleyebilen bir vaskülittir. Çalışmada renal tutulumu olan HSP’lı hastalarda anjiotensin konverting enzim (ACE) gen polimorfizminin prognozla ilişkisini araştırdık
Materyal ve Metot: HSP nefriti tanısı ile izlenen ACE gen polimorfizmi çalışılmış 0-18 yaş arası 42 hasta çalışmaya alındı. Hastalar delesyon (DD) allelline sahip olanlar (Grup1) ile heterozigot delesyon (ID) veya insersiyon (II) allelline sahip olanlar (grup2) olarak ayrıldı; iki grup tanı yaşları, cinsiyet dağılımı, renal tutulumun ağırlık derecesi açısından karşılaştırıldı.
Bulgular: Grup 1’de (DD) 15 erkek 14 kız toplam 29 hasta vardı, ortalama yaşları 8,26±3 yıl, izlem süreleri 3,34±2,1 yıldı. Grup 2’de (ID/II) 6 erkek 7 kız toplam 13 hasta vardı, ortalama yaşları 7,92±3,1 yıl, izlem süreleri 2,1±1,9 yıl idi. İki grup arasında cinsiyet dağılımı, yaş ve izlem süreleri bakımından istatiksel bir fark görülmedi. Grup 1’de 11 hastada hafif, 14 hastada orta, 4 hastada ciddi renal tutulum gözlendi. Grup 2’de 4 hastada hafif, 8 hastada orta, 1 hastada ciddi renal tutulum gözlendi. Renal tutulumun ağırlığı açısından gruplar arasında istatiksel olarak anlamlı bir fark görülmedi. Proteinüri düzelme oranı grup1’de (DD), grup2’den (ID,II) daha düşüktü, sırası ile (%31,2), (%62,5), ancak vaka sayıları az olduğundan istatiksel olarak anlamlı bulunmadı [ID veya II/ID (OR):3,667, (%95 Cl 0,619- 21,739)].
Sonuç: Renal tutulumu olan HSP’li çocuklarda böbrek tutulumunun ağırlığı ile DD genotipi veya D allelli arasında anlamlı bir ilişki görülmedi, ancak daha geniş ölçekli çalışmalarla desteklenmesi gereklidir.

Keywords

ACE, Gen, Polimorfizm, Nefrit, Henöch-Shönlein, Purpura

Supporting Institution

YOK

THE ASSOCİATİON OF ANGİOTENSİON CONVERTİNG ENZYME GENE POLİMORPHİSM WİTH PROGNOSİS OF HENOCH-SHONLEİN PURPURA WİTH RENAL İNVOLVEMENT İN THE CHİLDREN

Abstract

Objective: Henoch-Schönlein purpura (HSP) is a vasculitis rarely progresses to renal failure. In this study, we investigated association between angiotensin converting enzyme (ACE) gene polymorphism and prognosis of HSP nephritis.
Materials and Methods: Forty-two patients with HSP nephritis and ACE gene polymorphism studied were included in the study. Those who have deletion (DD) allele and heterozygous deletion (ID) or insertion (II) allele classified into 2 groups, then compared according to age of diagnosis, gender distribution, severity of renal involvement.
Results: In Group-1 (DD), of the 29 patients, 15 boys and 14 girls, their mean age was 8.26 ± 3 years, follow-up time was 3.34 ± 2.1 years. In group-2 (ID / II) of the 13 patients 6 boys and 7 girls, their mean age was 7.92 ± 3.1 years, follow-up time was 2.1 ± 1.9 years. In group-1, renal involvement was mild in 11, moderate in 14, and severe in 4 patients. In group-2 4 patients had mild, 8 patients had moderate and 1 patient had severe renal involvement. There was no statistically significant difference in severity of renal involvement between two groups. Although there was a difference in proteinuria recovery rates between the two groups, the number of cases was not enough for statistical analysis [ID or II / ID (OR): 3,667, (95% Cl 0.619-21.739).
Conclusion: There was no significant association between the severity of renal involvement of HSP with DD genotype or D allele, however, this needs to be supported by studies with larger series.

Keywords

ACE, Gene, Polimorphism, nephritis, Henoch-Shönlein, Purpura

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