The Relationship between Peripheral Blood Immunoglobulin，Erythrocyte Sedimentation Rate，Homocysteine and the Degree of Central Nervous System Vasculitis in Children and Their Influence on Prognosis

Xinyi MEN; Jing ZHAO; Yongchun SHEN; Hui JI; Xiuxia WANG

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Xinyi MEN, Jing ZHAO, Yongchun SHEN, Hui JI, Xiuxia WANG. The Relationship between Peripheral Blood Immunoglobulin，Erythrocyte Sedimentation Rate，Homocysteine and the Degree of Central Nervous System Vasculitis in Children and Their Influence on Prognosis[J]. Journal of Kunming Medical University.

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The Relationship between Peripheral Blood Immunoglobulin，Erythrocyte Sedimentation Rate，Homocysteine and the Degree of Central Nervous System Vasculitis in Children and Their Influence on Prognosis

1.
Department of Pediatrics，The 2nd Hospital of Hebei Medical University
2.
Department of Neurology，Shijiazhuang 050000，China
3.
Department of Pediatrics，Hebei Veterans General Hospital，Xingtai 054000，China

Received Date: 2024-01-30

Abstract

Abstract

Objective To investigate the relationship between peripheral blood immunoglobulin, erythrocyte sedimentation rate （ESR）, homocysteine （Hcy） and the severity of central nervous system vasculitis （CNSV） in children, as well as its impact on prognosis. Methods A total of 103 children with CNSV from February 2018 to February 2023 were selected as the study group, and 103 healthy children as the control group. The peripheral blood levels of immunoglobulin A （IgA）, immunoglobulin G （IgG）, immunoglobulin M （IgM）, ESR, and Hcy were compared between the 2 groups to evaluate the relationship between each index and the degree of CNSV disease [Birmingham vasculitis disease activity score （BVAS）] and its predictive value for prognosis. Results The levels of peripheral blood IgA, IgG, IgM, ESR, and Hcy in the study group were higher than those in the control group of healthy children （P < 0.05）; the BVAS scores and the levels of peripheral blood IgA, IgG, IgM, ESR, and Hcy in children with active disease were higher than those in children with inactive disease （P < 0.05）; the levels of peripheral blood IgA, IgG, IgM, ESR, and Hcy were positively correlated with the BVAS scores in children with CNSV （P < 0.05）; two cases were lost to follow-up after 6 months. Among the children with CNSV, 76 had good prognosis and 25 had poor prognosis. The levels of peripheral blood IgA, IgG, IgM, ESR, and Hcy in children with poor prognosis were higher than those in children with good prognosis （P < 0.05）; before and after correcting for other factors, peripheral blood IgA, IgG, IgM, ESR, and Hcy were all independent factors affecting the prognosis of children with CNSV （P < 0.05）; the area under curve （AUC） of peripheral blood IgA, IgG, IgM, ESR, and Hcy for predicting the prognosis of children with CNSV was 0.747, 0.808, 0.841, 0.839, and 0.746, respectively, with optimal cutoff values of 350.58 mg/dL, 1513.06 mg/dL, 124.84 mg/dL, 51.22 mm/h, and 13.66 μmol/L, respectively; the AUC of peripheral blood IgA, IgG, IgM, ESR, and Hcy for jointly predicting the prognosis of children with CNSV was 0.943 （95%CI: 0.878-0.979）, with a sensitivity of 92.00% and a specificity of 93.42%, which was superior to individual prediction of each indicator. Conclusion Peripheral blood IgA, IgG, IgM, ESR, and Hcy are positively correlated with the severity of CNSV. Abnormally high expression increases the risk of poor prognosis, and the combined predictive value is reliable.
- Children's central nervous system vasculitis,
- Immunoglobulin,
- Blood sedimentation rate （ESR）,
- Homocysteine,
- The degree of illness,
- Prognosis,
- Predictive value

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