M. Fujieda et al., SOLUBLE THROMBOMODULIN AND ANTIBODIES TO BOVINE GLOMERULAR ENDOTHELIAL-CELLS IN PATIENTS WITH HENOCH-SCHONLEIN PURPURA, Archives of Disease in Childhood, 78(3), 1998, pp. 240-244
Aim-To evaluate the clinical significance of soluble thrombomodulin an
d antiendothelial cell antibodies (AECA) in children with Henoch-Schon
lein purpura. Methods-Binding of serum AECA to bovine glomerular endot
helial cells was evaluated by enzyme linked immunosorbent assay, cytot
oxicity against glomerular endothelial cells by spectrophotometric ass
ay, and soluble thrombomodulin concentrations by sandwich enzyme immun
oassay. Results-IgA AECA were detected in seven of 15 patients with He
noch-Schonlein purpura and nephritis, but were not detected inpatients
without nephritis or in controls. Patients with Henoch-Schonlein neph
ritis had raised titres of IgA AECA and serum thrombomodulin; severe p
roteinuria and renal histological changes were associated with raised
titres of IgA AECA and raised serum thrombomodulin. No subjects had co
mplement dependent cytotoxicity against glomerular endothelial cells.
Conclusions-High titres of IgA AECA and raised serum thrombomodulin ma
y be clinically useful markers of renal involvement in patients with H
enoch-Schonlein purpura.