Tissue factor pathway inhibitor in paediatric patients with nephrotic syndrome
Objectives. To evaluate plasma TFPI levels in paediatric patients with nephrotic syndrome (NS) and its correlation with disease activity.
Subjects and methods. Fifteen nephrotic patients in relapse (proteinuria >40 mg/m2/h, hypo-albuminaemia and oedema) before initiating steroid therapy (group I) and another 15 nephrotic patients in remission after withdrawal of steroid therapy (group II) were compared with 15 age- and sex-matched healthy children (group III). Besides clinical evaluation and routine laboratory investigations of NS, tissue factor pathway inhibitor levels in plasma were measured by enzyme-linked immunosorbent assay (ELISA).
Results. Plasma TFPI levels were higher in nephrotic patients during relapse (group I) and during remission (group II) (mean 102.53 (standard deviation (SD) 14.23) and 82.93 (SD 3.83) ng/ml, respectively) compared with those in the control group (62.40 (SD 7.53) ng/ml) (p<0.0001). In children with NS, plasma TFPI levels were higher during relapse (group I) compared with levels in remission (group II) (p<0.0001). There was a negative correlation between the plasma TFPI level and total protein and serum albumin, and a positive correlation between the TFPI level and the urinary protein/creatinine ratio (p<0.05).
Conclusion. NS was associated with an increased level of plasma TFPI in comparison with the control group, and the increase was more apparent in patients with active disease.
Farida Ahmed Farid, professor of pediatrics
Ahmed Abdullah Mohammed, Associate professor of pediatrics
Rania Saleh Beltagi, Master degree in pediatrics
Hanaa Mohammed Afifi, professor of clinical pathology
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Date published: 2011-12-06
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