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Editor,—We were interested in the paper by Söylemezoǧlu et al concerning circulating soluble adhesion molecule expression in 20 children with acute Henoch-Schönlein purpura and 12 normal controls.1
We recently performed enzyme linked immunoassays (ELISAs) for ICAM-1 and E-selectin in the plasma of 41 children presenting to the Royal Hospital for Sick Children in Glasgow with acute Henoch-Schönlein purpura. Samples were analysed using commercially available ELISA kits for ICAM-1 (Predicta, Genzyme Diagnostics, Cambridge, MA, USA) and E-selectin (Parameter, R&D Systems Europe, Abingdon). Results were compared with reference ranges provided by the manufacturers.
Our results broadly support the findings of Söylemezoǧluet al. Of 41 paired measurements, ICAM-1 was raised in one case only, in keeping with the results reported by Söylemezoǧlu where acute and control levels did not differ (though there was a difference between acute and convalescent samples). E-selectin however, was raised in 12 (29%) of our cases. In those reported by Söylemezoǧlu there was no significant difference in E-selectin between active or inactive Henoch-Schönlein purpura and normal controls.
These data therefore confirm the findings of Söylemezoǧluet al in that we are unable to demonstrate increases in soluble ICAM-1 or E-selectin in the majority of paediatric patients with acute Henoch-Schönlein purpura. It is our clinical impression that the raised E-selectin levels found in a minority of our subjects may reflect the presence of more severe systemic and renal vasculitis (seven of the 12 having significant proteinuria and/or haematuria). This however requires confirmation by a prospective study comparing inflammatory markers and clinical status.
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