儿童紫癜性肾炎

1、会计学1儿童紫癜性肾炎儿童紫癜性肾炎n慢性肾炎型乙酰半乳糖胺半乳糖唾液酸半乳糖基化作用半乳糖缺乏O-linked glycans(white circles) N-linked glycans (black circles)IgA1分子分子结构结构Upper respiratory tract infectionGastrointestinal infection Production of Anti-glycan IgG or IgA1 Polymeric Gd- antibodies bind to Gd Formation of IgA1-IgG and IgA1- IgA1 immun

2、eGlomerular Activation of mesangial cellsInitiation of glomerular inflammation(cellular proliferation, matrix expansion)HSPN pathogenesisMcCarthy HJ, Tizard EJ. Clinical practice: Diagnosis and management of Henoch-Schnlein purpura.Eur J Pediatr. 2010 Jun;169(6):643-50我国儿童我国儿童HSPN的肾脏病理以的肾脏病理以级和级和级为主

3、级为主，极少，极少V级和级和级级没有可靠的数据能提供中度没有可靠的数据能提供中度HSPN特特异的治疗方案异的治疗方案 Bogdanovi R. Henoch-Schnlein purpura nephritis in children: risk factors, prevention and treatment. Acta Paediatr. 2009 Dec;98(12):1882-9 Corticosteroid therapy does not prevent nephritis in Henoch-Schonlein purpura. Pediatr Nephrol 1994; 8:

4、 131 A randomized, placebo-controlled trial of prednisone in early Henoch Schonlein purpura. BMC Med 2004; 2: 17 Early prednisone therapy in Henoch-Schonlein purpura: a randomized, double-blind, placebo-controlled trial. J Pediatr 2006; 149: 2417 Randomised placebo controlled trial to assess the role of early prednisolone on the development and progression of Henoch-Schonlein purpura nephritis. Pediatr Nephrol 2007; 22: 1457Chartapisak W, et al. Arch Dis Child 2009; 94: 1327没有证据支持糖皮质激素治疗能预防HSP肾损害的发生 McCarthy HJ, Tizard EJ. Clinical practice: Diagnosis and