IgA vasculitis nephritis clinical course and kidney biopsy - national study in children

• Published in: Pediatric Rheumatology 2021-10, Vol.19 (1), p.150-150, Article 150
• Main Authors: Mizerska-Wasiak, Małgorzata, Turczyn, Agnieszka, Cichoń-Kawa, Karolina, Małdyk, Jadwiga, Miklaszewska, Monika, Drożdż, Dorota, Bieniaś, Beata, Sikora, Przemysław, Drożyńska-Duklas, Magdalena, Żurowska, Aleksandra, Szczepańska, Maria, Pańczyk-Tomaszewska, Małgorzata
• Format: Article
• Language: English
• Subjects: Abdomen; Adolescent; Age; Antibodies; Biopsy; Biopsy - methods; Child; Child, Preschool; Children; Clinical trials; Creatinine; Development and progression; Disease Progression; Female; Follow-Up Studies; Hematuria; Henoch-Schönlein purpura and other vasculitides; Humans; Hypertension; IgA Vasculitis - diagnosis; IgA Vasculitis - epidemiology; Immunoglobulin A; Immunologic subjects; Kidney - pathology; Male; Medical research; Medicine, Experimental; Nephritis; Nephritis - diagnosis; Nephritis - epidemiology; Pain; Pediatrics; Poland - epidemiology; Population Surveillance; Registries; Retrospective Studies; ROC Curve; Severity of Illness Index; Vasculitis
• ISSN: 1546-0096; 1546-0096
• DOI: 10.1186/s12969-021-00616-z

The aim of the study was to investigate the relationship between the severity of typical clinical symptoms, severity of histopathological lesions in kidney biopsies in IgA vasculitis nephritis (IgAVN) and to propose indications for kidney biopsy in children. This retrospective study enrolled 106 patients, included in the IgAVN registry of Polish children, diagnosed by kidney biopsy. Renal and extrarenal symptoms at onset of the disease were analyzed. Biopsy results were assessed using Oxford classifications (MEST-C). The patients were divided into 3 groups depending on the severity of proteinuria: A-nephrotic proteinuria with hematuria; B-non-nephrotic proteinuria with hematuria; C-isolated hematuria. The first symptoms of nephropathy were observed at the 0.7 (1-128.4) months from the onset of extrarenal symptoms. Kidney biopsy was performed on 39 (6-782) days after the onset of nephropathy symptoms. MEST-C score 4 or 5 was significantly more frequent in children from group A than in groups B and C. Significantly higher mean MEST-C score was found in patients with abdominal symptoms than without. In group A: S0 and T0 we found in significantly shorter time to kidney biopsy than in S1, T1-2 p