患有IgA血管炎与炎的儿童的临床过程和管理
Hillarey K Stone1,2, Mark Mitsnefes3,4, Kimberley Dickinson5,6
1Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC 7022, Cincinnati, OH, 45229, USA. hillarey.stone@gmail.com.
Pediatric nephrology (Berlin, Germany)
|June 14, 2023
概括
儿童的IgA血管炎与炎很少导致慢性病或功能衰竭. 严重病例的免疫抑制可以改善IgA血管炎 (IgAV) 患者的结果.
科学领域:
- 儿科脏病学 儿科脏病学
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
背景情况:
- IgA血管炎 (IgAV) 是儿童最常见的血管炎.
- 急性炎 (IgAVN) 是 IgAV 的常见并发症.
- 在患有IgAVN的儿童中,慢性病 (CKD) 的长期风险尚不清楚.
研究的目的:
- 在一大批被诊断患有IgAVN.的儿童中调查临床管理和结局.
- 评估儿童IgAVN患者中CKD和衰竭的发生率.
- 基于不同治疗策略的结果进行比较.
主要方法:
- 使用PEDSnet数据库进行的一项观察性队列研究 (2009年1月 - 2020年2月).
- 鉴定了患有IgAV的儿童,并分析了患有脏病的儿童.
- 将治疗分类为观察,RAAS阻断,皮质类固醇和其他免疫抑制.
主要成果:
- 对1139名患有IgAVN的儿童进行了平均1.7年的随访.
- 保守管理 (观察/RAAS封锁) 是最常见的 (63%).
- 2.6%患有CKD,0.5%患有功能衰竭;在更严重的病例中使用免疫抑制.
结论:
- 患有IgAVN的儿童的结局在有限的随访期内通常是有利的.
- 免疫抑制疗法可能与严重IgAVN呈现的改善结果有关.
- 需要进一步的研究来证实免疫抑制的长期益处.
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