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Article Type

Original Study

Abstract

Objective The aim of this study is to assess the level of protein Z (PZ) as a risk factor for thrombosis in children with nephrotic syndrome (NS). Background NS results from any of several well-described primary glomerulopathies that are defined by histopathology and clinical criteria. The main pathomechanism of complications originates from the large loss of plasma proteins in the urine of nephrotic children, and thromboembolism is among the most serious complications. PZ plays an important role in inhibiting coagulation, serving as a cofactor for the inactivation of activated factor X by plasma-PZ-dependent protease inhibitor. Decreased PZ may contribute to an increased risk of thromboembolic complications in children with NS. Patient and methods The study included 45 children divided into three groups: group I included 15 patients in active stage of NS, group II included 15 patients in remission stage, and group III included 15 apparently healthy age-matched and sex-matched patients as controls. Patients were subjected to the following: history taking and clinical examination, assessment of weight, height, and edema, platelet count, prothrombin time, activated partial thromboplastin time, creatinine, urine protein/creatinine ratio, serum albumin, cholesterol, and antithrombin III (ATIII) level assay by radial immunodiffusion and PZ level assay by enzyme-linked immunosorbent assay. Results There were highly statistical significant differences regarding platelet count (P = 0.000), urine protein/creatinine ratio (P = 0.000), serum albumin (P = 0.000), cholesterol (P = 0.000), ATIII (P = 0.000), and PZ (P = 0.000) between the studied groups. Conclusion PZ level in plasma and ATIII level were found to be lower in children with NS in active stage, and this may contribute to an increased risk of thromboembolic complications in children with NS.

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