Journal of Clinical Pediatrics

The strategy of diagnosis and treatment of anti-neutrophil cytoplasm antibody-associated vasculitis

XIA Zhengkun, ZHOU Qingshan, GAO Yuanfu, FAN Zhongmin

. 2016, 34(6): 401. doi:10.3969 j.issn.1000-3606.2016.06.001

Abstract ( 374 )

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Anti-neutrophil cytoplasm antibody-associated vasculitis (ANCA) is an autoimmune disease with multi organ involvement characterized by vascular wall inflammation and fibrinoid necrosis, including microscopic polyangitis (MPA), granuloma polyangitis (GPA), and eosinophilic granuloma polyangitis (EGPA). Because its clinical manifestations are complicated and non-specific, it is difficult to make early diagnose. In recent years, some new progress has been made in diagnosis and treatment of this disease. The article will review the related information.

Renal vascular damage and the expression of miR-145 in lupus nephritis

LIU Hua, HE Xiaojie, HU Zhilan

. 2016, 34(6): 406. doi:10.3969 j.issn.1000-3606.2016.06.002

Abstract ( 309 )

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Objective To evaluate renal vascular damage (RVLs) and detect the expression of miR-145 in children with lupus nephritis (LN). Methods Clinical data of 41 cases of LN diagnosed by renal biopsy from the children with systemic lupus erythematosus (SLE) were collected. Glomerular damage score and RVLs were evaluated. The children were divided into groups according to RVLs score and pathological pattern. In situ hybridization was performed to detect the expression of miR-145 in kidney blood vessel. Differences in RVLs, miR-145 expression in the renal blood vessels and glomerular damage score were observed among the groups with different renal pathological pattern. Differences in clinical parameters, glomerular damage score and miR-145 expression in the renal blood vessels were investigated among groups with different RVLs. Results Among the groups with different pathological pattern, there was no difference in RVLs (P > 0.05) while significant different were found in the expression of miR-145 and glomerular damage score (P < 0.01). Among the groups with different RVLs, both clinical indexes and glomerular damage score were similar (P > 0.05) while a statistical different was found in the expression of miR-145 (P < 0.01). Conclusions Children with LN had RVLs and the miR-145 may be involved in development of RVLs.

The relationships of hyperuricemia with clinical and Oxford classifications in children with IgA nephropathy

LIU Yang, WEI Jinfeng, ZHOU Xuemei, LI Changchun, ZHANG Zhihao, HE Fagui

. 2016, 34(6): 411. doi:10.3969 j.issn.1000-3606.2016.06.003

Abstract ( 357 )

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Objective To investigate the relationships of hyperuricemia with clinical and Oxford classifications in children with IgA nephropathy. Methods Clinical data of 213 children with IgA nephropathy were retrospective analyzed. According to the levels of blood uric acid, these children were divided into two groups, hyperuricemia group (n = 51) and normal uric acid group (n = 162). Differences of clinical index and Oxford classification between the two groups were observed. Results The 24 h urinary protein, level of serum creatinine, glomerular filtration rate (eGFR) in hyperuricemia group were significantly higher than those in normal group (P all < 0.05). Oxford classification showed that the degree of mesangial cell proliferation (M1) and renal tubular atrophy/interstitial fibrosis (T1-2) in hyperuricemia group were more serious than in normal uric acid group (P all < 0.01). Conclusions Children with IgA nephropathy combined with hyperuricemia were worse in clinical index and pathological manifestations. Increased serum uric acid may be one of the important factors that contribute to poor prognosis of children with IgA nephropathy.

The clinical and pathological features of capillary proliferative purpura nephritis in 19 children

SONG Chundong, DING Ying, ZHAI Zonggang, ZHAI Wensheng, REN Xianqing, GUO Qingyin, ZHANG Xia, YANG Meng, ZHANG Jian

. 2016, 34(6): 414. doi:10.3969 j.issn.1000-3606.2016.06.004

Abstract ( 343 )

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Objective To explore the clinical and pathological features, treatment, and prognosis of capillary proliferative purpura nephritis (DEP-HSPN) in children. Methods The clinical data of 19 children diagnosed with DEP-HSPN were retrospectively analysis. Fifty-five children diagnosed with HSPN by renal biopsy were randomly selected as control group. Results The average age was 10.6±2.6 years old, and the average course of disease were 19.4±7.4 days before renal biopsy in 19 children with DEP-HSPN (14 males and 5 females) who make up 3.92% of anaphylactic purpura nephritis children confirmed by renal biopsy in the same period. In these 19 children, there were 10 cases having nephrotic syndrome and 9 case having hematuria and proteinuria type, all of whom were received immunosuppressive therapy. Finally, 14 cases achieved completely remission and 5 cases had partly remission. All of their classifications of renal pathology were Ⅲb levels, accompanied with 6.38% to 36.36% of crescents. Compared with 55 age and sex matched children with renal pathology classification of Ⅲb, the DEPHSPN children had shorter disease course, higher level of proteinuria, and lower pathological score of chronic renal injury (P all < 0.05). There was similar percentage of crescent between two groups. Conclusions Children with DEP-HSPN usually have rapid onset, severe clinical manifestations, more active lesions and less chronic lesions. There is no evidence that the capillary proliferative lesion is a risk factor in the prognosis of HSPN so far.

Diagnosis and treatment of 6 cases of Dent’s disease

. 2016, 34(6): 418. doi:10.3969 j.issn.1000-3606.2016.06.005

Abstract ( 438 )

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Objective To explore the diagnosis and treatment of Dent’s disease. Methods The clinical characteristics, treatment process and disease-causing gene mutation were retrospectively analyzed in 6 pediatric patients with Dent’s disease misdiagnosed of nephritic syndrome from January 2014 to August 2015. Results In these 6 male patients aged 4.5-9.8 years old, the main clinical manifestations were nephropathy-level of proteinuria and transient low serum albumin (26-30 g/L) without obvious edema or high serum cholesterol. In 4 patients who had renal biopsy, 2 cases showed mesangial proliferative glomerulonephritis and other 2 cases showed focal segmental glomerulosclerosis. All of 6 patients were treated with at least one immunosuppressive agent after resistance to full dose of hormone and no changes in proteinuria were observed. After admission, the indexes of early renal damage and urinary protein electrophoresis pointed to low-molecular proteinuria. The ratio of alpha 1 micro albumin (α1-MG) / micro albumin (MA) (the early renal damage index) was > 1, there was hypercalciuria, and renal function was normal. The B ultrasonography showed renal calcification in 2 patients. The findings in all the patients were in accord with the clinical diagnosis of Dent’s disease. Further genetic analysis confirmed the presence of CLCN5 gene mutation in these 6 patients. Conclusion As a type of rare inherited renal tubular disorder, Dent’s disease is easily misdiagnosed, to which pediatricians need to pay attention. The early renal damage index, α1-MG/MA > 1, can be regarded as one of the diagnostic criteria of renal tubular proteinuria.

The value of targeted surveillance in control of nosocomial infection in neonatal intensive care unit

WANG Mian, SU Weidong, WANG Qingqing, GAN Wensi

. 2016, 34(6): 421. doi:10.3969 j.issn.1000-3606.2016.06.006

Abstract ( 401 )

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Objective To explore the effect of targeted surveillance on the control of nosocomial infection in neonatal intensive care unit (NICU). Methods The nosocomial infection rates were retrospectively analyzed after continuous improvement of targeted surveillance in NICU from January 2013 to June 2015. Results During the research period, 59 cases has nosocomial infection in 1011 case who were selected in accordance with inclusion criteria, nosocomial infection rate is 5.8% and daily infection rate is 3.5%. On semiannual basis, the daily infection rates decreased from 8% in the first half of 2013 to 2.2% in the first half of 2015. The ventilator associated pneumonia cases/1000 ventilator days decreased from 12.8‰ to 0‰ from the first half of 2013 to the first half of 2015. The central ventral indwelling catheter related bloodstream infection cases/1000 central ventral indwelling catheter days decreased from 4.5‰ to 0‰ from the first half of 20133 to the first half of 2015. The differences were statistically significant (P all < 0.05). Conclusion Through continuous targeted surveillance, the dynamic changes of nosocomial infection and its risk factors can be monitored, so that the effective intervention can be carried out to decrease the nosocomial infection rate in NICU.

The distribution of pathogens and prognosis in ninety-five children with etiology confirmed bacterial meningitis

PENG Qiongling, WU Zhu, LIU Duoduo, TAO Shaohua

. 2016, 34(6): 425. doi:10.3969 j.issn.1000-3606.2016.06.007

Abstract ( 338 )

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Objective To explore the distribution of pathogens, bacterial drug resistance, clinical features and prognosis of bacterial meningitis (BM) in children. Methods The clinical data of children diagnosed with BM during January 2011 to July 2015 were retrospectively analyzed. Children were divided into good outcome group and poor outcome group by the outcome at discharge. The distribution of pathogens, bacterial drug resistance, clinical features, and prognosis were analyzed among different groups. Results There were included 95 children diagnosed with BM,. among whom 69 (72.6%) children had Grampositive bacterial infections with predominant Streptococcus pneumonia (43 cases, 45.3%) and 26 (27.4%) children had Gramnegative bacterial infections with predominant Escherichia coli (13 cases, 13.7%). More than 50% Streptococcus pneumonia and Escherichia coli were resisted to penicillin. The neurological complications in children with BM included subdural effusions, hydrocephalus, cerebral parenchyma injury, and hearing and visual impairment, et.al. Multivariate logistic regression analysis showed that consciousness, coma, and low level of glucose in cerebrospinal fluid were the independent risk factors for adverse outcome at discharge. Conclusion Streptococcus pneumonia and Escherichia coli were the predominant pathogens in children with BM with high resistance rate to penicillin. BM children may have varying degrees of neurological sequelae. The unconsciousness and low level of glucose in cerebrospinal fluid were associated with unfavorable outcomes at discharge.

Clinical characteristics of pleural effusion in children with Mycoplasma pneumoniae

HAO Xiaojing, LI Quanheng, GAO Wenjie, LI Jinying, Dong Weiran, WANG Yanyan, AN Shuhua

. 2016, 34(6): 430. doi:10.3969 j.issn.1000-3606.2016.06.008

Abstract ( 540 )

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Objective To explore the clinical characteristics of pleural effusion caused by Mycoplasma pneumoniae in children. Methods The clinical data from children with pleural effusion caused by Mycoplasma pneumoniae were retrospectively analyzed. Differences of clinical characteristics in children with pleural effusion caused by Mycoplasma pneumoniae infection and non-Mycoplasma pneumoniae infection were compared. Moreover, multiple logistic regression analysis was performed on the factors that were identified to have statistical differences in single factor analysis. Receiver operating characteristic (ROC) curve was performed and the diagnostic boundary value of each factor and the diagnostic accuracy of the regression model were calculated. Results There were statistical differences between children with pleural effusion caused by Mycoplasma pneumoniae infection and by non-Mycoplasma pneumoniae infection in age, white blood cell count, lactic dehydrogenase (LDH), levels of IgA and IgM, and the proportion of multiple nuclei, glucose and lactic acid (LAC) in pleural effusion, pleural thickening, and formation of fibrous separation (all P < 0.05). Multifactor logistic regression found the differences of age, levels of IgM and LDH, level of LAC are statistically different between the two groups (all P < 0.05), with their diagnostic boundary value of 3.92 years old, 1.29 g/L, 367 U/L and 4.02 mmol/L, respectively. ROC under the curve (AUC) was 0.887 (95% CI: 0.830-0.944, P < 0.001). Conclusion In children having pleural effusion caused by pneumonia of unknown pathogen, if their age is > 3.92 years, serum IgM > 1.29 g/L, LDH > 367 U/L and pleural effusion LAC < 4.02 mmol/L, Mycoplasma pneumoniae infection should be highly suspected.

Epidemiologic and clinical features of hand, foot, and mouth disease caused by Coxsackie virus A16 infection in Suzhou and analysis of polymorphisms of OAS1

LUO Yali, CAI Yanyan, JI Wei, DING Ying, CHU Chu, ZHOU Weifang, YOU Haizhang

. 2016, 34(6): 434. doi:10.3969 j.issn.1000-3606.2016.06.009

Abstract ( 422 )

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Objective To explore the epidemiologic and clinical features of hand, foot and mouth disease (HFMD) caused by Coxsackie virus A16 (CA16) in Suzhou from 2010 to 2014, and analyze the relationship between the SNPs of oligoadenylate synthetase 1 (OAS1) and HFMD caused by CA16 infection. Methods The clinical data of children diagnosed with HFMD caused by CA16 during 2010 and 2014 were collected. The epidemiological characteristics were analyzed. Among them, 167 cases were selected to make comparison of the clinical features with 166 cases of HFMD caused by EV71 infection in the same period. The genotyping of OAS1 rs10774671 was detected by TaqMan probe technique in 167 cases of CA16 infection children, 166 cases of EV71 infection children with HFMD and 163 healthy children. The relationship between polymorphism of gene and infection of CA 16 was analyzed. Results A total of 9 016 children with HFMD were included. CA16 nucleic acid detected to be positive in 762 cases. The detection rate was 8.45%. CA16 infection was most commonly in summer. Children under 5 years old accounted for 94.62% infected. Compared with EV71 infected children, CA16 infected children had shorter fever time, severer oral herpes, ulcer, and rash in hand, foot and hip, lesser nervous system involvement, fewer cases of high lactate dehydrogenase, high C reactive protein, high IgM or IgG, and significant changes in the percentage of CD3+, CD3+CD4+, CD3+CD8+ and CD3－CD19+ (P all < 0.05). The frequency of GG genotype was significantly higher in CA16 infected HFMD children in OAS1 rs10774671 compared with healthy children (P = 0.475). There was no difference in the genotype OAS1 distribution of rs10774571 between common and severe CA16 infected HFMD group (P = 0.475). Conclusion The epidemiology of CA16 infected HFMD disease in Suzhou area was related with age and season. CA16 infected HFMD children have different clinical features and laboratory characteristics.. Children with OAS1 rs10774671 GG genotype were more susceptible to CA16.

Analysis of related risk factors of neonatal resuscitation difficulty

AN Xiaoxia, WANG Jimei, HU Jing, WANG Huijuan, LU Chengqiu, YANG Min

. 2016, 34(6): 439. doi:10.3969 j.issn.1000-3606.2016.06.010

Abstract ( 390 )

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Objective To analyze related risk factors in resuscitation difficulty in neonates. Methods Live birth asphyxia neonates with gestational age≥28 weeks (1 minute Apgar score count of 0-7) were included during January 2011 to October 2015. After resuscitation, the neonates were divided into two groups by 5 minutes Apgar score, successful resuscitation group (Apgar score of 8-10) and poor resuscitation group (Apgar score of 0-7). The analysis of related risk factors was performed. Neonates with poor resuscitation assessed by 5 minutes Apgar were continued being resuscitated. After 20 minutes, these neonates were divided into successful resuscitation group (20 minutes Apgar 8-10) and poor resuscitation group (20 minutes Apgar 0-7). The related risk factors analysis was performed once again. Results A total of 743 neonates with asphyxia at one minute were included, among whom 130 cases were poor resuscitation and 613 cases were successful resuscitation at 5 minutes. There were obvious correlations of 5 minutes poor resuscitation with premature delivery, low birth weight, 1 minute Apgar score for 0 ~ 3, intrapartum infectious fever, abnormal placenta, vaginal bleeding during late pregnancy, twin transfusion syndrome, and fetal malformation (P all < 0.05). Neonates with 5 minutes poor resuscitation continued being resuscitated, 32 cases were still poor resuscitation at 20 minutes, and compared with 98 cases of successful resuscitation, there were statistical differences in 1 minute and 5 minutes Apgar score of 0 ~ 3 (P all < 0.05). Two cases of vasa praevia and eight cases of fetal edema neonates were still poor resuscitation at 5 minutes and 20 minutes who were asphyxia at one minute. Conclusion There are many factors affecting the resuscitation of asphyxia neonates, among which vasa praevia and fetal edema are most adverse factor in neonatal resuscitation difficulty.

Clinical features of congenital hepatic fibrosis in children

WU Xin, DU Xiaorang, DING Jinfang, WU Mengjin, LUO Shengqiang, FENG Xingzhong

. 2016, 34(6): 444. doi:10.3969 j.issn.1000-3606.2016.06.011

Abstract ( 402 )

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Objective To explore the clinical features of congenital hepatic fibrosis (CHF) in children. Methods A total of 111 patients diagnosed with CHF during January 2002 to June 2015 were included and divided into children group and adult group according to the age at diagnosis. The clinical data including gender, age, clinical symptoms, signs, laboratory examinations, and imaging characteristics were retrospectively analyzed and compared between two groups. Results There were high incidences of splenomegaly and liver cirrhosis in both children and adult groups, and no difference was found between two groups (P > 0.05). The fatigue, jaundice, and hepatosplenomegaly were more common in children group while the renal cyst and liver cyst were more common in adult group, and the differences were statistically significant (P all < 0.05). Compared with adult group, the abnormal rate of ALT, AST, ALP, LAP, TBA, and AST were significantly higher in children group (P all < 0.05). Conclusion CHF patients often have hepatocirrhosis and splenomegaly. CHF patients diagnosed in childhood have more sever hepatosplenomegaly, are more in high levels of ALT, AST, ALP, LAP, and TBA, and less in renal cyst and hepatic cyst.

Lissencephaly: a case report and literature review

JIANG Jun, LI Cheng, ZHAO Peiwei, HE Xuelian

. 2016, 34(6): 449. doi:10.3969 j.issn.1000-3606.2016.06.012

Abstract ( 469 )

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Objective To explore the clinical features of lissencephaly and the detection of LISI gene. Methods The characteristic of clinical features, laboratory examination and gene detection in one case of lissencephaly was retrospectively analyzed. Meanwhile, the related literatures were reviewed. Results A 5-month-old female child diagnosed with epilepsy 20 days ago was hospitalized for convulsive seizure more than 30 times in 3 days. The manifestations were eyes staring, and turning upward, cyanosis of lips and face, froth at the mouth, extremities rigidity and loss of consciousness, and the symptoms can spontaneously remitted in 2-3 minutes. Laboratory examination showed that peripheral blood white cell count was 13.67×10⁹/L, hemoglobin 108 g/L, red blood cell count 3.90×10¹²/L, lymphocyte 10.26×10⁹/L; maocardial enzyme and hepatic and renal function were normal; blood ammonia was 23 μmol/L and lactic acid 2.11 mmol/L. Long-range video EEG showed highly arrhythmia, and frequent partial epilepsy, and sometimes secondary generalized epilepsy. Head MRI showed lissencephaly. The child was treated with oral administration of Keppra 27 mg/(kg·day), Topiramate 6.5 mg/(kg·day), currently no seizure. The detection of LIS1 gene found that heterozygous mutation of c.232delG, which lead to protein shift mutation (p.E78NfsX25). No mutation was found in her parents. Conclusions Child with lissencephaly may combine with epilepsy which may cause by mutation in LIS1 gene. And there was no information about point mutation of c.232delG in LIS1 gene being reported at home and abroad so far.

Deep venous thrombosis in preterm infants: 3 cases report

HU Qi, FAN Wenting, DENG Rui, LIAO Wei

. 2016, 34(6): 453. doi:10.3969 j.issn.1000-3606.2016.06.013

Abstract ( 523 )

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Objective To enhance the awareness of diagnose and treatment of venous thrombus in premature infants. Methods The clinical features, treatment and prognosis of lower limb vein thrombus in three case of premature infants were retrospectively analyzed. Results Three premature infants of gestational age 29-36 weeks were found thrombosis in 1-57 days after birth. One case received peripherally inserted central cathete (PICC). All of three cases had infection signs and trauma. One case received thrombolytic and anticoagulant therapy, one case received high dose thrombolytic therapy, and both of them were treated successfully without bleeding complication. However, another case was deteriorated after giving up treatment. Conclusions Critically ill premature infants are at high risk of thrombosis. Infection, indwelling tube, thrombophilia constitution, and maternal risk factors were the high risk factors of thrombosis. Early detection, early diagnosis, and effective individualized treatment can improve the prognosis.

Drug-induced hypersensitivity syndrome in children: a case report

ZHAO Yan, HUANG Ying

. 2016, 34(6): 457. doi:10.3969 j.issn.1000-3606.2016.06.014

Abstract ( 462 )

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Objective To analyze the diagnose and treatment of drug-induced hypersensitivity syndrome (DIHS) in children. Methods The clinical data from one case of highly suspected DIHS were retrospectively analyzed. The related literatures were reviewed. Results A 22-month-old male child with severe pneumonia, after treated with vancomycin, suffered with high fever and skin rash combined with hepatic lesion and hematological system disorder. After withdrawal of vancomycin and then treatment with the combination of high-dose methylprednisolone and intravenous immunoglobulin, the clinical symptoms were gradually relieved in 24 hours. The child was improved and discharged on 17th day. Conclusion The child has the characteristics of DIHS which is highly suspected to be caused by vancomycin.

Clinical diagnosis, treatment, and prognosis of pulmonary artery sling in 38 children

ZHOU Gan, ZHANG Guangli, ZHANG Hui,ZOU Xin, CHEN Ming, MENG Qingqing, HE Ling, LUO Zhengxiu

. 2016, 34(6): 461. doi:10.3969 j.issn.1000-3606.2016.06.015

Abstract ( 326 )

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Objective To explore the clinical characteristics and prognosis of congenital pulmonary artery sling (PAS) in children. Methods The clinical data of 38 children diagnosed with PAS during June 2009 and February 2015 were retrospectively analyzed. Results In 38 PAS children, 35 cases (89.47%) were hospitalized for varying degrees of respiratory manifestations with recurrent cough (89.47%) and wheezing (84.21%) being the most common. The remaining 3 cases were found abnormal in routine preoperative examination and the diagnosis was confirmed after further examination. All 38 children were performed computer tomography angiography (CTA). Thirty-seven cases were diagnosed of PAS and diagnostic rate was 97.37%. One case was suspected of pulmonary dysplasia and diagnosed of PAS after operation. Twenty-six children received surgical treatment, of whom 25 children had pulmonary artery reconstruction (LPA). Seven children died during/after operation and 18 survived. The remaining 12 children received non-surgical treatment, of whom 9 died and 3 survived. Conclusion Cardiac uhrasonography may reveal PAS in the early stage, while CTA is the best method for confirmed diagnosis. LPA reconstruction is an important means of relieving left pulmonary artery oppression.

Effect of mibefradil on proliferation of human pulmonary artery smooth muscle cells induced by platelet-derived growth factor

LI Honghong, XIAO Tingting, XIE Lijian, HUANG Min, SHEN Jie

. 2016, 34(6): 465. doi:10.3969 j.issn.1000-3606.2016.06.016

Abstract ( 354 )

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Objectives To explore the effect of mibefradil, a kind of novel calcium channel antagonists, on proliferation of human pulmonary artery smooth muscle cells (HPASMCs) induced by platelet-derived growth factor (PDGF). Methods HPASMCs were cultured in vitro, and randomly divided into control group, PDGF group, Mib group, and PDGF+Mib group. The PDGF group was stimulated by 25 ng/ml of PDGF. Mib group was intervented by 10 μmol/L of Mib. PDGF+Mib group was treated by PDGF and Mib. The reproduction rate in 48 hours and 72 hours were detected by MMT. Cell cycle was detected by flow cytometry. The expression of proliferating cell nuclear antigen (PCNA) was observed by immunofluorescence staining (IFS). Results There were statistical differences among four groups in both 48 hours and 72 hours (P all < 0.05), especially in 72 hours. PDGF group had the highest level of HPASMC reproduction rate, and there were statistical differences as compared with the other three groups (P all < 0.05). However, the HPASMC reproduction rates were similar among PDGF+Mib group, Mib group, and control group (P all > 0.05). There were statistically differences of G0/G1 phase and S phase among four groups (P < 0.05). PDGF group had lowest G0/G1 phase cells and highest S phase cells, and there were statistically differences as compared with the other three groups (P all < 0.05). No differences were found among PDGF+Mib group, Mib group, and control group (P all < 0.05). There was obviously difference in the expression of PCNA among four groups (P < 0.05). PDGF group had the highest expression of PCNA and there were statistically differences as compared with other three groups, (P < 0.05). While the expression of PCNA was similar among PDGR+Mib group, Mib group, and control group. Conclusion Mibefradil was able to restrain remarkably the proliferation of HPASMC by inhibit the cell cycle that stimulated by PDGF, and by the expression of PCNA.

The role of zinc finger protein A20 in immune regulation of dendritic cells and in the pathogenesis of inflammatory bowel disease

ZHENG Cuifang, HUANG Ying

. 2016, 34(6): 470. doi:10.3969 j.issn.1000-3606.2016.06.017

Abstract ( 481 )

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Ubiquitin plays a vital role in both protein degradation and many kinds of cellular functions, such as DNA damage repair, cell cycle regulation, cell growth and immune system function.Ubiquitin modified enzyme zinc finger protein A20 is considered to be an important gateway for the regulation of immune and inflammatory responses, which is a key negative regulator in NF-κB signaling pathway. Dendritic cell (DC) is a full-time antigen presenting cell that identifies inflammatory response or pathogenic microorganism by multiple receptors, and is a key moderator for immunity homeostasis. Researches in recent years showed that A20 plays an important role in regulating the function of DC, which may take part in the occurrence and development of inflammatory bowel disease. In this article, the regulation of A20 in the immunoregulation of DC and its function on the pathogenesis of inflammatory bowel disease were reviewed.

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