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Plasma E-selectin and ICAM-1 in acute Henoch-Schönlein purpura
  1. F R WILLIS
  1. Princess Margaret Hospital for Children
  2. Perth, Western Australia
  3. Cardiff Royal Infirmary
  4. Cardiff
  5. Renal Unit
  6. Royal Hospital for Sick Children
  7. Yorkbill, Glasgow G3 8SJ
    1. G C SMITH
    1. Princess Margaret Hospital for Children
    2. Perth, Western Australia
    3. Cardiff Royal Infirmary
    4. Cardiff
    5. Renal Unit
    6. Royal Hospital for Sick Children
    7. Yorkbill, Glasgow G3 8SJ
      1. T J BEATTIE
      1. Princess Margaret Hospital for Children
      2. Perth, Western Australia
      3. Cardiff Royal Infirmary
      4. Cardiff
      5. Renal Unit
      6. Royal Hospital for Sick Children
      7. Yorkbill, Glasgow G3 8SJ

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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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