The Change of Immunologic Parameters in Acute Poststreptococcal Glomerulonephritis

Kim, Doh Hee; Lee, Seung Woo; Lee, Kyung Yil; Yoon, You Sook; Hwang, Ja Young; Rhim, Jung Woo; Koh, Dae Kyun; Lee, Joon Sung

Abstract

PURPOSE: This study was aimed to evaluate the changes of immunologic parameters during hospitalization, and the relationship between IgG and other laboratory or clinical indices in patients with acute poststreptococcal glomerulonephritis (APSGN).
METHODS
We reviewed the medical charts of 36 children with APSGN who showed ASO titer >250 Todd U/L and C3<70 mg/dL. We evaluated the levels of IgG and other laboratory parameters including C3 and ASO at admission and at discharge (14 cases).
RESULTS
The mean age of APSGN patients was 7.5+/-2.6 year of age, and male-to-female ratio was 2.3:1. At presentation, hypertension (systolic blood pressure>125 mmHg), gross hematuria, and weight gain were observed in 27.8% (10/36), 80.1% (29/36), and 80% (24/30) of the patients, respectively. The mean IgG level was 1,432+/-322 mg/dL (1,025+/-234 mg/dL in control group, P< 0.001), and C3 and ASO levels were 26.1+/-16.1 mg/dL and 1,068+/-730 Todd U, respectively. There were no correlation between IgG level and the levels of any of the parameters analyzed (ASO, C3, BUN, creatinine and white blood cell count), and the severity of the disease assessed by the weight-change during admission. The patients aged<6 years of age (10 cases) had less degree of the weight-change, compared to those of the patients aged>8 years of age (15 cases) (-0.6% vs. -5.7%, P=0.01). The IgG and ASO levels did not change, but C3 (P=0.001) and IgM (P=0.02) levels increased during admission.
CONCLUSION
Increased IgG and ASO levels in APSGN did not change, but C3 level increased during admission. IgG level was not correlated with other laboratory parameters (ASO and C3) and the severity of the disease. Younger children seem to have less severe clinical course compare to older children. With our hypothetic pathogenesis of APSGN, further studies are needed to resolve the pathogenesis of the disease including the increase of IgG.