THE SIGNIFICANCE OF THE LEVEL OF AVERAGE WEIGHT MOLECULES IN BLOOD PLASMA, AS AN INDICATOR OF ENDOGENOUS INTOXICATION, IN PREDICTING GLOMERULONEPHRITISIS IN CHILDREN WITH HEMORRHAGIC VASCULITIS
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Abstract
Purpose of the study – to assess the level of molecules of average mass in blood plasma, as an indicator of endogenous intoxication, as a predictor of the development of glomerulonephritis in children with hemorrhagic vasculitis.
Material and methods. 74 children with hemorrhagic vasculitis were examined. Patients are divided into 3 groups. Group I included 53 patients with the abdominal form, group II included 21 patients with the articular form of vasculitis. Group III was formed retrospectively in the amount of 21 patients from patients in group I, when they developed clinical and laboratory signs of glomerulonephritis at 3-5 weeks from the onset of the disease. The content of molecules of average mass was determined by direct spectrometry of the deproteinized supernatant after precipitation of proteins with a solution of trichloroacetic acid at a wavelength of 254 nm. The control group consisted of 23 healthy peers.
Results. The main deviations in the indicator of molecules of average mass, indicating the level of endogenous intoxication, were noted in children with the abdominal form of vasculitis and, especially, in patients with developed glomerulonephritis. A higher level of endogenous intoxication correlated with the severity of the patients' condition. The indicators of average mass molecules established in such cases were statistically significantly higher than those recorded not only among healthy children of the control group, but also in the group of patients with the articular form of the disease. Among the reasons for the development of endogenous intoxication syndrome, it is necessary to take into account the presence of a current, widespread inflammatory-destructive process in the tissues of the microvasculature of the “shock” organs, as well as intoxication associated with the infectious process often suffered on the eve of vasculitis.
Conclusion. It is advisable to use the determination of the indicator of molecules of average mass as an additional criterion for the severity of hemorrhagic vasculitis and a prognostic factor for the development of glomerulonephritis.
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Lyiskina GA, Kikinskaya EG, Zinoveva GA, Frolkova EV. Porazhenie pochek pri bolezni Shenlejna-Genoxa u detej. Pediatria n.a. G.N. Speransky. 2005; 84(5): 22-28. Russian (Лыскина Г.А., Кикинская Е.Г., Зиновьева Г.А., Фролкова Е.В. Поражение почек при болезни Шенлейна-Геноха у детей //Педиатрия. Журнал им. Г.Н. Сперанского. 2005. Т. 84, № 5. С. 22-28)
Podchernjaeva NS, Kudrjashova MA, Frolkova EV, Korotkova EA. Does early glucocorticoid therapy reduce risk for nephritis in children with Henoch-Schönlein purpura? Doktor.ru. 2014; 11(99): 31-35. Russian (Подчерняева Н.С., Кудряшова М.А., Фролкова Е.В., Короткова Е.А. Снижает ли ранняя терапия глюкокортикоидами риск развития нефрита при болезни Шенлейн-Геноха у детей? //Доктор.ру. 2014. № 11(99). С. 31-35)
Xu L, Li Y, Wu X. IgA vasculitis update: Epidemiology, pathogenesis, and biomarkers. Front Immunol. 2022; 13: 921864. DOI: 10.3389/fimmu.2022.921864
Dyga K, Szczepańska M. IgA vasculitis with nephritis in children. Adv Clin Exp Med. 2020; 29: 513-519. DOI: 10.17219/acem/112566
Jauhola O, Ronkainen J, Koskimies O, Ala-Houhala M, Arikoski P, Holtta T, et al. Clinical Course of Extrarenal Symptoms in Henoch-Schonlein Purpura: A 6-Month Prospective Study. Arch Dis Child. 2010; 95: 871-876. DOI: 10.1136/adc.2009.167874
Dudnikova JeV, Harlamova AV. Endogenous intoxication in children with chronic gastroduodenitis and gastroesophageal reflux disease. Kuban Scientific Medical Bulletin. 2011; 2(125): 42-45. Russian (Дудникова Э.В., Харламова А.В. Эндогенная интоксикация у детей с хроническим гастродуоденитом и гастроэзофагеальной рефлюксной болезнью //Кубанский научный медицинский вестник. 2011. № 2(125). С. 42-45)
Naletov AV, Guz NP, Masjuta DI. Dynamics of indicators of endogenous intoxication when using various options of anti-Helicobacter therapy in children with erosive and ulcerative pathology of the duodenum. Gastrojenterologija Sankt-Peterburga. 2016; 1-2: 24-27. Russian (Налетов А.В., Гуз Н.П., Масюта Д.И. Динамика показателей эндогенной интоксикации при использовании различных вариантов антихеликобактерной терапии у детей с эрозивно-язвенной патологией двенадцатиперстной кишки //Гастроэнтерология Санкт-Петербурга. 2016. № 1-2. С. 24-27)
Shevchenko SS, Grekova AI. Estimation of molecules of average and low mass, peptides of serum in infants with pneumonia and ARVI. Children infections. 2015; 14(1): 9-12. Russian (Шевченко С.С., Грекова А.И. Оценка уровня молекул средней и низкой массы у детей раннего возраста при пневмонии и ОРВИ //Детские инфекции. 2015. № 14(1). С. 9-12.) DOI: 10.22627/2072-8107-2015-14-1-9-12
Kaukonen KM, Bailey M, Pilcher D, Cooper DJ, Bellomo R. Systemic inflammatory response syndrome criteria in defining severe sepsis. N Engl J Med. 2015; 372(17): 1629-1638. DOI: 10.1056/NEJMoa1415236
Tuychiboeva MN. The estimation of modern methods of laboratory researches of toxic components of blood in diagnostics of degree of the intoxication of endotoxicose patients. Herald of institute of postgraduate education in health sphere. 2011; 2: 46-49. Russian (Туйчибоева М.Н. Оценка современных методов лабораторных исследований токсичных компонентов крови в диагностике степени интоксикации больных эндотоксикозами //Вестник института последипломного образования в сфере здравоохранения. 2011. № 2. С. 46-49)
Kuznecov PL, Borzunov VM. Syndrome of endogenous intoxication in the pathogenesis of viral hepatitis. Experimental & clinical gastroenterology. 2013; 4: 44-50. Russian (Кузнецов П.Л., Борзунов В.М. Синдром эндогенной интоксикации в патогенезе вирусного гепатита //Экспериментальная и клиническая гастроэнтерология. 2013. № 4. С. 44-50)
Massy ZA, Liabeuf S. Middle-Molecule Uremic Toxins and Outcomes in Chronic Kidney Disease. Contrib Nephrol. 2017; 191: 8-17. DOI: 10.1159/000479252
Breda L, Carbone I, Casciato I, Gentile C, Grasso EA, di Donato G, et al. Epidemiological and clinical aspects of immunoglobulin A vasculitis in childhood: a retrospective cohort study. Ital J Pediatr. 2021; 47(1): 237. DOI: 10.1186/s13052-021-01182-6
Gabrijeljan NI, Dmitriev AA, Kulakov GP. Diagnosticheskaya cennost` opredeleniya srednix molekul v plazme krovi pri nekroticheskix zabolevaniyax. Klinicheskaja medicina. 1981; 10: 38-42. Russian (Габриэлян Н.И., Дмитриев А.А., Кулаков Г.П. Диагностическая ценность определения средних молекул в плазме крови при некротических заболеваниях //Клиническая медицина. 1981. Т. 59, № 10. С. 38-42)
Karyakina EV, Belova SV. Medium mass molecules as an integral indicator of metabolic disorders (literature survey). Klinicheskaja laboratornaja diagnostika. 2004; 3: 3-8. Russian (Карякина Е.В., Белова С.В. Молекулы средней массы как интегральный показатель метаболических нарушений (обзор литературы) //Клиническая лабораторная диагностика. 2004. № 3. С. 3-8)
Halafjan AA. Modern statistical methods of medical research. M., 2008. 316 р. Russian (Халафян А.А. Современные статистические методы медицинских исследований. Москва, 2008. 316 с.)
Yepifantseva NN, Borshchikova TI, Churlyaev YuA, Ratkin IK, Nikiforova NV, KlochkovaAbelyants SA, Kheringson LG. Oxidant-Antioxidant Balance in Severe Brain Injury. General Reanimatology. 2010; 6(1): 22-27. Russian (Епифанцева Н.Н., Борщикова Т.И., Чурляев Ю.А., Раткин И.К., Никифорова Н.В., Клочкова-Абельянц С.А., Херингсон Л.Г. Состояние оксидантно-антиоксидантного равновесия при тяжелой черепно-мозговой травме //Общая реаниматология. 2010. Т. 6, № 1. С. 22-27.) DOI: 10.15360/1813-9779-2010-1-22
Krutikova MS, Cholah BG, Fedoseeva VM, Hrenov AA, Naumova NV, Kacev AM. Proteinuria and endogenous intoxication in patients with liver cirrhosis. Tavricheskiy mediko-biologicheskiy vestnik. 2022; 23(3): 61-66. Russian (Крутикова М.С., Чолах Б.Г., Федосеева В.М., Хренов А.А., Наумова Н.В., Кацев А.М. Протеинурия и эндогенная интоксикация у больных циррозом печени //Таврический медико-биологический вестник. 2022. № 23(3). С. 61-66.) DOI: 10.37279/2070-8092-2020-23-3-61-66