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Clinical Study of the Correlation of Tumor Necrosis Factor Alpha and the Proteinuria of Henoch-Schönlein Nephritis and Idiopathic Nephrotic Syndrome

Journal of the Korean Pediatric Society 2002;45(2):240-246.
Published online February 15, 2002.
Clinical Study of the Correlation of Tumor Necrosis Factor Alpha and the Proteinuria of Henoch-Schönlein Nephritis and Idiopathic Nephrotic Syndrome
Dong-Ho Jeong1, Jeong-Hyun Park1, Hye-Cheon Jeong1, Hyun-Hoe Koo1, Jun-Ho Lee2, Tae-Sun Ha1
1Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea
2Department of Pediatrics, College of Medicine, Pochon Cha Uuniversity, Bundang, Korea
Henoch-Schönlein Purpura 신염과 특발성신증후군에서 Tumor Necrosis Factor Alpha와 단백뇨와의 관련성에 관한 임상적 연구
정동호1, 박정현1, 정혜천1, 구현희1, 이준호2, 하태선1
1충북대학교 의과대학 소아과학교실
2포천중문의과대학 소아과학교실
Correspondence: 
Tae-Sun Ha, Email: tsha@med.chungbuk.ac.kr
Abstract
Purpose
: It is not clear that the development of glomerular injury and aggravation by tumor necrosis factor alpha(TNF-α) is related to intrarenal or serum concentration of TNF-α. So, we studied the relationship between the concentration of TNF-α and aggravation of glomerular damage in the Henoch-Schönlein nephritis(HSN) and idiopathic nephrotic syndrome(INS).
Methods
: We collected the sera and urines of 21 patients with Henoch-Sch nlein purpura(HSP) and 22 patients with INS visited Chungbuk National University hospital from March 1998 to March 2001. The concentration of TNF-α in the sera and urines were measured by sandwich ELISA.
Results
: Serum TNF-α levels in the HSP patients with renal involvement were significantly higher than those without renal involvement(P=0.009). But urine TNF-α levels have no correlation with renal involvement(P=0.088). In the HSN patients, proteinuria have a significant correlation with serum TNF-α levels(P=0.004) but less correlation with urine TNF-α levels(P=0.053). Otherwise, proteinuria have no correlation with serum TNF-α levels(P=0.763) but have a significant correlation with urine TNF-α levels(P=0.007) in INS.
Conclusion
: These result suggest that the serum concentration of TNF-α would be important to glomerular involvement in HSP. And, it is interesting that proteinuria shows a significant relation with serum TNF-α levels in the HSN, but with urine TNF-α levels in the INS. This means the major production of TNF-α may be originated by extrarenal inflammation in the HSN and by intrarenal tubulo-interstitial damage due to proteinuria in the INS.
Key Words: Tumor necrosis factor-α, Proteinuria, Henoch-Schö, nlein nephritis, Idiopathic nephrotic syndrome


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