Association of Matrix Metalloproteinase-9 Level with the Risk of Renal Involvement for Henoch–Schönlein Purpura in Children

Zhou, Tian-Biao; Yin, Sheng-Sheng

doi:10.3109/0886022x.2012.757826

Cited by 17 publications

(10 citation statements)

References 17 publications

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“…The pooled statistics were counted using the fixed effects model, but a random effects model was used when the p value of the heterogeneity test was less than 0.1. 10,11 Results were expressed with odds ratios (OR) for dichotomous data, and 95% confidence intervals (CI) were also calculated. p50.05 was required for the pooled OR to be statistically significant.…”

Section: Discussionmentioning

confidence: 99%

Relationship between methylenetetrahydrofolate reductase (MTHFR) A1298C gene polymorphism and type 2 diabetic nephropathy risk: a meta-analysis

Zhang¹,

Xiao²,

Zhang

et al. 2014

Renal Failure

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In the sensitivity analysis according to the Hardy-Weinberg equilibrium (HWE), the results were consistent with those in non-sensitivity analysis. However, in the sensitivity analysis according to the control source from hospital, sample size of case (100), sample size of case (5100), the MTHFR A1298C gene polymorphism was not associated with T2DN risk. In conclusion, the MTHFR A1298C gene polymorphism was not associated with T2DN risk. However, additional studies are required to firmly establish a correlation between the MTHFR A1298C gene polymorphism and T2DN risk.

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Section: Discussionmentioning

confidence: 99%

Relationship between methylenetetrahydrofolate reductase (MTHFR) A1298C gene polymorphism and type 2 diabetic nephropathy risk: a meta-analysis

Zhang¹,

Xiao²,

Zhang

et al. 2014

Renal Failure

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“…There are also reports of increased levels of matrix metalloproteinases (MMPs) in the fluid from bullous lesions demonstrated by immunochemistry staining [19]. This is an interesting finding because a recent meta-analysis of pediatric patients with HSP by Zhou et al found a strong association of nephritis with serum and even urinary levels of matrix metalloproteinase-9 [OR=77.21, 95% CI: 54.56–99.86 and p<0.00001] [20]. Our patient had no past history of bullous lesions but he probably did have association with pressure areas because he wore elastic stockings.…”

Section: Discussionmentioning

confidence: 95%

Bullous Skin Lesions in an Adult Male: A Diagnostic Dilemma

2015

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Patient: Male, 42Final Diagnosis: Henoch-Schönlein Purpura (HSP)Symptoms: Bullous hemorrhagic lesions • elevated liver enzymesMedication: —Clinical Procedure: —Specialty: RheumatologyObjective:Unusual clinical courseBackground:Henoch-Schönlein Purpura (HSP) is an IgA small-vessel vasculitis that is primarily a disease of childhood. Its presentation in adulthood is rare and has a more severe disease course. We present a case with an atypical presentation of this disease that was a diagnostic challenge for multiple providers.Case Report:A 42-year-old man noticed bullous lesions over his ankles that spread to his entire legs over a few weeks. They later became necrotic and ulcerated areas. His primary care physician and 2 dermatologists could not reach a definitive diagnosis. He then presented to our hospital with new abdominal pain, rectal bleeding, and a new elevation in liver enzymes. A biopsy of his skin lesions led to the diagnosis of HSP.Conclusions:We discuss this highly unusual initial presentation with bullous skin lesions and liver enzyme abnormalities and explore the medical literature to understand its pathogenesis. Clinicians need to be aware of this rare presentation to avoid a delay in diagnosis and management.

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“…In a meta-analysis evaluating eight studies, the serum MMP-9 level was reported to be a risk factor for the development of HSPN (26). All eight studies were conducted in a Chinese population, with seven published in Chinese and only one published in English (7).…”

Section: Discussionmentioning

confidence: 99%

“…In a meta-analysis evaluating four studies, the urinary MMP-9 level was found to be increased in patients with HSPN and hence it could be used as an early indicator (26). In this study, the urinary MMP-9 level of the patients with HSPN was higher than that of the patients without renal involvement and the control group.…”

Section: Discussionmentioning

confidence: 99%

Potential of Serum and Urinary Matrix Metalloproteinase-9 Levels for the Early Detection of Renal Involvement in Children With Henoch-Schönlein Purpura

et al. 2016

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BackgroundMatrix metalloproteinase-9 (MMP-9) is an enzyme implicated in the pathogenesis of renal diseases. Renal involvement is the principal cause of morbidity and mortality in children with Henoch-Schönlein purpura (HSP).ObjectivesThe aim of this study was to evaluate whether serum and urinary MMP-9 levels are associated with renal involvement in HSPPatients and MethodsWe evaluated 40 children with HSP (patient group) and 27 healthy volunteer children (control group). The patient group was divided into two subgroups based on the presence or absence of nephritis. Nephritis was defined as the existence of hematuria and/or proteinuria. All anthropometric data, physical examination findings, blood pressure, and laboratory parameters were recorded. The serum and urine samples were analyzed to determine the MMP-9 levels three days after the initial phase of the disease.ResultsThe mean age was 7.65 ± 3.41 (range 2 - 16) years in the patient group and 9.52 ± 3.91 (range 2 - 16) years in the control group. Henoch-Schonlein purpura nephritis (HSPN) was identified in eight patients. There was no significant difference in the serum MMP-9 levels between the HSPN subgroup and the controls (P > 0.05). However, there were significant differences in the urinary MMP-9 levels between the HSP subgroup and the control group (P < 0.05), with the urinary MMP-9 levels being significantly higher in patients in the HSP subgroup (P = 0.001). Further, the urinary MMP-9 levels were significantly higher in the patients with nephritis than in the patients without nephritis (P = 0.001) and the controls (P = 0.001). The optimal cut-off point (sensitivity; specificity) of the urinary MMP-9 level for the diagnosis of HSPN was 94.7 pg/mL.ConclusionsThe levels of MMP-9 in the urine were remarkably high in patients with HSPN. This non-invasive marker may therefore be an important indicator for the early diagnosis of nephritis in children with HSP.

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Association of Matrix Metalloproteinase-9 Level with the Risk of Renal Involvement for Henoch–Schönlein Purpura in Children

Cited by 17 publications

References 17 publications

Relationship between methylenetetrahydrofolate reductase (MTHFR) A1298C gene polymorphism and type 2 diabetic nephropathy risk: a meta-analysis

Relationship between methylenetetrahydrofolate reductase (MTHFR) A1298C gene polymorphism and type 2 diabetic nephropathy risk: a meta-analysis

Bullous Skin Lesions in an Adult Male: A Diagnostic Dilemma

Potential of Serum and Urinary Matrix Metalloproteinase-9 Levels for the Early Detection of Renal Involvement in Children With Henoch-Schönlein Purpura

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