IgM in lesional skin is indicative of renal involvement in adults with Henoch-Schönlein purpura but not children

Henoch-Schönlein purpura and systemic disease in children: retrospective study of clinical findings, histopathology and direct immunofluorescence in 34 paediatric patients

“…We determined the most commonly found combination of conjugates in childhood HSP to be IgA and fibrinogen (85%), similar to the recent finding of IgA and fibrinogen being present in 92% of adult biopsies . The combination of IgA and IgG was the least frequently observed, only present in two (6%) biopsies, which is also consistent with other paediatric and adult DIF studies …”

“…A recent adult study found that 84% of adult HSP skin biopsies had three or more conjugates present . Likewise, a paediatric study by Tirado‐Sánchez et al . found the presence of IgA and C3 in 85% of biopsies, IgA and IgM in 53%, IgA and fibrinogen in 12%, and IgA and IgG in 3%.…”

“…found that in patients older than 40 years, the absence of perivascular eosinophils was associated with a nearly threefold increased risk of renal involvement. In studies using direct immunofluorescence (DIF), the presence of IgM has been inconsistently associated with renal involvement . To our knowledge, histopathological correlates of systemic disease have not been previously studied in the paediatric population.…”

The correlation between cutaneous IgM deposition and renal involvement in adult patients with Henoch-Schönlein purpura

“…In another study, including adult cases, conducted by Poterucha et al, the records of forty-seven patients were reviewed and no correlation between the IgM deposition and any systemic involvement was found in DIF examinations of skin biopsy specimens, however, lack of fibrin deposition was found to be correlated with renal involvement [6]. Tirado-Sánchez et al reviewed the medical records of thirty-seven children and they noticed no correlation between IgM deposition in DIF examination and renal involvement [24]. In our study, the relationship between the IgM deposition, along with IgA, in skin lesions detected by DIF and systemic involvement was investigated and a significant correlation was found between the deposition of IgM in DIF examination and renal involvement (p = 0.003), similar to the results obtained by Takeuchi et al [5].…”

Correlates of systemic disease in adult Henoch-Schönlein purpura: A retrospective study of direct immunofluorescence and skin lesion distribution in 87 patients at Mayo Clinic

“…Possibly, some services did not consistently perform DIF microscopy on skin biopsy specimens, thus excluding those patients and biasing the study as a result. Also, the study took place during a 20-year period, and there were several (approximately [6][7][8] immunopathologists who interpreted DIF specimens during the time frame. However, a systematic and uniform process exists among the immunopathologists at our institution for the interpretation of DIF specimens, which should help to minimize any possible differences in technique.…”