Evaluation of the electrophoresis of serum proteins in cases of nephrotic syndrome in senegalese children

Authors:Ndour EHM,*, Ndongo AA, Guèye Tall F, Sagna Bassène HAT, Thiongane A, Djité M, Keita Y , Sène LN, Guèye PM,Cissé A, Lopez Sall P
Int J Biol Med Res. 2019; 10(4): 6877-6881  |  PDF File

Abstract

Introduction Child nephrotic syndrome (NS) is defined by the association of proteinuria > 50 mg/kg/24h, proteinemia < 60 g/l and albuminemia < 30 g/l. α2-globulinemia is frequently increased i.e. > 11 g/l. There are reportedly very few data on the evaluation of biological parameters of NS in Senegal. We therefore sought to evaluate the electrophoretic profile of serum proteins in child NS. Materials and methods This is a retrospective observational analytical study of 48 nephrotic children. Proteinuria and proteinemia were determined; serum protein electrophoresis was performed. The nephrotic index (NI) defined by the α-2 globulins/albumin ratio and the disturbance frequencies of the protein fractions were calculated. The averages were compared using the Student T test. Results The children had a median age of 85 months [15 - 180] and the sex-ratio was 2.27. The study included 31 pure nephrotic (PNS) and 17 impure (INS). Proteinuria, proteinemia and albuminemia were 114.87±8.62 mg/kg/24 hours, 47.2±0.99 g/l and 16.05±0.94 g/l. The electrophoresis showed a decrease in serum protein and albumin in all nephrotics and a frequent decrease in γ-globulins (50%) and β-globulins (41.67%). α1-globulins were significantly increased in INS compared to PNS (3.46±3.18 versus 1.78±0.82; p = 0.046). The rise in α1-globulins was quite frequent (33.33%), especially among INS (58.82%) compared to PNS (19.35%). A more frequent increase in NI (95.83%) than α2-globulins (87.50%) was observed. Compared to non hyperα-2-globulinemics, hyperα2-globinemics showed a significant decrease in proteinemia, albuminemia and γ-globulinemia. Conclusion The association between hypoalbuminemia and increased NI is reported to be a more sensitive marker of NS in Senegalese children than the association between hypoalbuminemia and hyperα-2-globulinemia. The increased synthesis of α2-globulins would be by a phenomenon of amino acid remobilization from albumin and γ-globulins. α1-globulins appear to be the only protein fraction that can be used as a differential marker between pure and impure nephrotic.