Association of Pediatric Vasculitis Activity Score with immunoglobulin A vasculitis with nephritis,Pediatric Nephrology

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Association of Pediatric Vasculitis Activity Score with immunoglobulin A vasculitis with nephritis
Pediatric Nephrology ( IF 2.6 ) Pub Date : 2022-07-27 , DOI: 10.1007/s00467-022-05675-2
Begüm Avcı ₁ , Tuba Kurt ₂ , Fatma Aydın ₃ , Elif Çelikel ₂ , Zahide Ekinci Tekin ₂ , Müge Sezer ₂ , Nilüfer Tekgöz ₂ , Cüneyt Karagöl ₂ , Serkan Coşkun ₂ , Melike Mehveş Kaplan ₂ , Umut Selda Bayrakçı ₄ , Banu Acar ₂

Affiliation

Background

Immunoglobulin A vasculitis with nephritis (IgAVN) is the most serious complication affecting long-term prognosis. Understanding the risk factors and markers for the development of IgAVN is essential. The aim of this study is to identify IgAVN-associated factors and to evaluate the usability of Pediatric Vasculitis Activity Score (PVAS) at diagnosis as an early marker for the development of IgAVN.

Methods

We conducted a retrospective case–control study of 314 patients divided into two groups: those with nephritis (IgAVN) and without nephritis (non-IgAVN). The groups were compared in terms of clinical symptoms, laboratory values, and PVAS values.

Results

In total, 18.5% of the patients had IgAVN; they were older than the non-IgAVN patients (median age was 8.8, p < 0.05). Arthritis/arthralgia, abdominal pain, and intestinal bleeding were more common, systolic and diastolic BP were higher in IgAVN (p < 0.05). CRP, serum creatinine, and urine protein/Cr, PVAS were higher, while serum albumin was lower in IgAVN (p < 0.05). The receiver operator characteristic curve (ROC) analysis showed that IgAV patients with a determined cut-off PVAS value greater than 3 had 70.7% sensitivity in predicting whether or not they would develop IgAVN. Logistic regression analysis found that PVAS > 3 and low serum albumin at the time of diagnosis were independent risk factors for IgAVN.

Conclusion

Our study revealed that PVAS > 3 at diagnosis is an independent predictor of IgAVN. Patients with PVAS > 3 should be followed more closely to ensure early diagnosis and management of IgAVN.

Graphical abstract

A higher resolution version of the Graphical abstract is available as Supplementary information

中文翻译：

小儿血管炎活动评分与免疫球蛋白 A 血管炎与肾炎的关联

背景

免疫球蛋白 A 性血管炎伴肾炎 (IgAVN) 是影响长期预后的最严重并发症。了解 IgAVN 发生的风险因素和标志物至关重要。本研究的目的是确定 IgAVN 相关因素，并评估诊断时小儿血管炎活动评分 (PVAS) 作为 IgAVN 发展早期标志物的可用性。

方法

我们对 314 名患者进行了回顾性病例对照研究，将其分为两组：肾炎组 (IgAVN) 和无肾炎组 (non-IgAVN)。比较各组的临床症状、实验室值和PVAS值。

结果

总共 18.5% 的患者患有 IgAVN；他们比非 IgAVN 患者年龄更大（中位年龄为 8.8 岁， p < 0.05）。 IgAVN 中关节炎/关节痛、腹痛和肠道出血更常见，收缩压和舒张压较高 ( p < 0.05)。 IgAVN 中 CRP、血清肌酐、尿蛋白/Cr、PVAS 较高，而血清白蛋白较低 ( p < 0.05)。受试者工作特征曲线 (ROC) 分析显示，确定的 PVAS 截止值大于 3 的 IgAV 患者在预测是否会发生 IgAVN 方面的敏感性为 70.7%。 Logistic回归分析发现PVAS> 3和诊断时低血清白蛋白是IgAVN的独立危险因素。