患有IgA血管炎相关炎的儿童免疫抑制的结果
Katharina Rohner1, Matko Marlais2,3, Yo Han Ahn4
1Department of Pediatric Nephrology, University Children's Hospital Zurich, Zurich, Switzerland.
概括
免疫球蛋白A血管炎与炎 (IgAVN) 治疗缺乏基于证据的指导方针. 这项研究发现,对于儿科IgAVN没有特定的免疫抑制疗法优越,突出了进一步研究的必要性.
科学领域:
- 儿科脏病学 儿科脏病学
- 血管炎研究 血管炎研究
- 临床结果 临床结果
背景情况:
- 免疫球蛋白A血管炎与炎 (IgAVN) 是最常见的儿童血管炎.
- 目前的治疗建议缺乏强有力的证据,导致实践变化.
- 这项研究旨在在一大批儿科IgAVN队列中确定预后因素和治疗疗效信号.
研究的目的:
- 为了描述临床表现,治疗和结果在一个大队伍的儿童与活检证明的IgAVN.
- 为了确定不良结果的预后风险因素.
- 评估IgAVN治疗疗效的信号.
主要方法:
- 对1148名生物检测证明IgAVN (2005-2019) 的儿童进行了回顾性分析.
- 数据来自25个国家的41个国际中心收集.
- 多变量分析的重点是估计的淋巴细胞过率 (eGFR) 和随访时持续的蛋白尿.
主要成果:
- 在平均3.7年的随访期间,29%的EGFR<90mL/min/1.73m2,36%的蛋白尿,3%的CKD4-5期.
- 年龄较大,发病时较低的EGFR,高血压,管状缩和细分性硬化预测了不良结果.
- 没有特定的二线免疫抑制疗法显示优越性;延迟治疗与较低的EGFR相关.
结论:
- 与IgAVN结局相关的关键特征在一个大队列中被确定.
- 没有证据支持针对IgAVN的特定免疫抑制治疗的优越性.
- 进一步的研究和临床试验对于确定最佳IgAVN治疗和改善结果至关重要.
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