在儿童患有严重或不典型的急性链球菌后球球球膜炎的组织学严重性的生物标志物
William Wong1, Chanel Prestidge2, Jonathan Zwi3
1Department of Paediatric Nephrology, Starship Children's Hospital, 3 Park Road, Grafton, Auckland, New Zealand. wwong@adhb.govt.nz.
Pediatric nephrology (Berlin, Germany)
|December 20, 2023
概括
在儿童中,严重的急性链球菌后血球膜炎 (APSGN) 与功能显著降低有关. 活检前估计较低的淋巴细胞过率 (eGFR) 有助于识别需要紧急干预的严重病例.
科学领域:
- 儿科脏病学 儿科脏病学
- 脏病理学 脏病理学
- 淋巴细胞疾病 淋巴细胞疾病
背景情况:
- 急性链球菌后血球膜炎 (APSGN) 可以呈现为快速进展的血球膜炎 (RPGN) 与严重的损伤在儿童的一个子集.
- 确定严重APSGN的风险因素对于及时诊断和管理至关重要.
研究的目的:
- 审查临床和实验室因素,以确定患有APSGN的儿童有严重疾病的高风险.
- 确定儿科APSGN.快速进展的疾病和质新月的预测因素.
主要方法:
- 从1996年至2020年对APSGN脏活检的回顾性审查.
- 提取和分析临床和实验室数据,包括估计的膜过率 (eGFR).
- 由病理学家进行脏活检的独立审查和评分.
主要成果:
- 56.6%的患者出现了第3期急性损伤 (AKI),其EGFR中位数为27毫升/分钟/1.73米2.
- 活检前的eGFR<35毫升/分钟/1.73米2或eGFR预测状新月率下降≥25% (p=0.004).
- 活检前的eGFR是状新月最准确的预测指标 (ROC 0.757).
结论:
- 严重的APSGN的特点是eGFR的显著减少.
- 计算eGFR可以帮助识别需要紧急脏活检的儿科患者,以准确诊断和治疗严重的APSGN.
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