Clinical and histopathological prognostic factors affecting the renal outcomes in childhood ANCA-associated vasculitis.
Objective: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are very rare in childhood with an increased risk of morbidity and mortality. We aimed to evaluate renal prognostic factors in childhood AAV from the perspective of ANCA serotype, histopathological classification, an...
| Published in: | Pediatric Nephrology Vol. 34; no. 5; pp. 847 - 855 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Springer Nature
May2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=135451187&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 135451187 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: May2019 vid: 34 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 135451187 135451187 135451187 10.1007/s00467-018-4162-5 135451187 ppf: 847 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Clinical and histopathological prognostic factors affecting the renal outcomes in childhood ANCA-associated vasculitis. aug: au: Özçelik, Gül Sönmez, Hafize Emine Şahin, Sezgin Özağarı, Ayşim Bayram, Meral Torun Çiçek, Rümeysa Yasemin Çakıcı, Evrim Kargın Çomak, Elif Barut, Kenan Şahin, Nihal Bakkaloğlu, Sevcan Gökçe, İbrahim Düzova, Ali Bilginer, Yelda Açarı, Ceyhun Melek, Engin Kılıç, Beltinge Demircioğlu Özdel, Semanur Adroviç, Amra Kasapçopur, Özgür affil: Department of Pediatric Nephrology, SBÜ. Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey sug: subj: Antibodies, Antineutrophil Cytoplasmic Adverse Effects Vasculitis Diagnosis Kidney Diseases Prognosis Human Child Turkiye Autoimmune Diseases Biopsy Methods Autoantibodies Blood Logistic Regression Creatinine Kidney Failure, Chronic Prognosis Vasculitis Mortality Socioeconomic Factors Outcome Assessment Pediatric Care Quality of Health Care Child: 6-12 years ab: Objective: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV) are very rare in childhood with an increased risk of morbidity and mortality. We aimed to evaluate renal prognostic factors in childhood AAV from the perspective of ANCA serotype, histopathological classification, and five-factor score (FFS).Methods: Pediatric AAV patients from 11 referral centers in Turkey had been included to the study. The demographics, clinical findings, AAV subtypes, outcomes, and FFS were evaluated retrospectively. Kidney biopsies were classified histopathologically.Results: Totally, 39 patients were enrolled in the study. Among all patients, 74.4% had renal involvement, 56.4% ear-throat-nose involvement, and 51.3% had musculoskeletal involvement. Proteinase 3 (PR3)-ANCA was positive in 48.7%, and myeloperoxidase (MPO)-ANCA was positive in 30.8%. 69.2% of patients had impaired renal function, and 28.2% had progressed to end-stage renal disease (ESRD) during the follow-up. At the time of diagnosis, FFS was ≥ 2 in 53.8%. The most common histopathologic classifications were as follows: crescentic type in 40.7% and sclerotic type in 25.9%. Gastrointestinal and renal involvement, MPO-ANCA positivity, serum creatinine levels, and impaired renal function during the follow-up were significantly higher in patients with FFS ≥ 2, compared to patients with FFS < 2. Patients with FFS ≥ 2 had more common crescentic, mixed and sclerotic histopathologic findings in biopsies. By logistic regression analysis forward method, the strongest single-risk factor among all the parameters was the initial level of creatinine in patients with ESRD, compared to the other patients (p = 0,007).Conclusions: Evaluation of the FFS, ANCA serology, and the creatinine levels may help to predict renal prognosis. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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