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

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Abstract

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.

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Authors and Affiliations

  1. Department of Pediatric Nephrology, Başkent University Faculty of Medicine, M.D., Gazi Paşa Mah. Baraj Cad. No:7, Seyhan, Adana, Turkey

    Begüm Avcı

  2. Department of Pediatric Rheumatology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey

    Tuba Kurt, Elif Çelikel, Zahide Ekinci Tekin, Müge Sezer, Nilüfer Tekgöz, Cüneyt Karagöl, Serkan Coşkun, Melike Mehveş Kaplan & Banu Acar

  3. Department of Pediatric Rheumatology, Ankara University Faculty of Medicine, Ankara, Turkey

    Fatma Aydın

  4. Faculty of Medicine, Department of Pediatric Nephrology, Ankara Yıldırım Beyazıt University, Ankara City Hospital, Ankara, Turkey

    Umut Selda Bayrakçı

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  1. Begüm Avcı
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Avcı, B., Kurt, T., Aydın, F. et al. Association of Pediatric Vasculitis Activity Score with immunoglobulin A vasculitis with nephritis. Pediatr Nephrol 38, 763–770 (2023). https://doi.org/10.1007/s00467-022-05675-2

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