MEST-C pathological score and long-term outcomes of child and adult patients with Henoch-Schönlein purpura nephritis
Abstract Background Henoch-Schönlein purpura nephritis (HSPN), a small-vessel vasculitis, shares renal pathological features with immunoglobulin A nephropathy. Oxford classification of immunoglobulin A nephropathy pathology has been updated to the MEST-C score, but its application in HSPN remains un...
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BMC
2020-01-01
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| Series: | BMC Nephrology |
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| Online Access: | https://doi.org/10.1186/s12882-020-1691-5 |
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| author | Donghwan Yun Dong Ki Kim Kook-Hwan Oh Kwon Wook Joo Kyung Chul Moon Yon Su Kim Kyoungbun Lee Seung Seok Han |
| author_facet | Donghwan Yun Dong Ki Kim Kook-Hwan Oh Kwon Wook Joo Kyung Chul Moon Yon Su Kim Kyoungbun Lee Seung Seok Han |
| author_sort | Donghwan Yun |
| collection | DOAJ |
| description | Abstract Background Henoch-Schönlein purpura nephritis (HSPN), a small-vessel vasculitis, shares renal pathological features with immunoglobulin A nephropathy. Oxford classification of immunoglobulin A nephropathy pathology has been updated to the MEST-C score, but its application in HSPN remains unresolved. Methods Two hundred and thirteen patients with biopsy-proven HSPN were retrieved from the Seoul National University Hospital between 2000 and 2017. Renal outcome risks (i.e., end-stage renal disease or doubling of serum creatinine) were evaluated according to MEST-C scores after stratification by age: 113 children aged < 18 years (9.2 ± 3.6 years) and 100 adults aged ≥18 years (38.6 ± 18.3 years). We pooled our data with four previous cohort studies in which MEST or MEST-C scores were described in detail. Results Twenty-one child (19%) and 16 adult (16%) patients reached the renal outcome during the median follow-up periods of 12 years and 13 years, respectively (maximum 19 years). In children, M1 and T1/T2 scores revealed worse renal outcomes than did M0 and T0 scores, respectively, whereas the T score was the only factor related to worse outcomes in adult patients after adjusting for multiple clinical and laboratory variables. The pooled data showed that M1, S1, and T1/T2 in children and E1 and T1/T2 in adults were correlated with poorer renal outcomes than those of their counterpart scores. Conclusions The Oxford classification MEST-C scores can predict long-term renal outcomes in patients with HSPN. |
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| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-16T16:40:32Z |
| publishDate | 2020-01-01 |
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| series | BMC Nephrology |
| spelling | doaj.art-0a1118cdcb16415198b52e335e9ae78e2022-12-21T22:24:20ZengBMCBMC Nephrology1471-23692020-01-012111810.1186/s12882-020-1691-5MEST-C pathological score and long-term outcomes of child and adult patients with Henoch-Schönlein purpura nephritisDonghwan Yun0Dong Ki Kim1Kook-Hwan Oh2Kwon Wook Joo3Kyung Chul Moon4Yon Su Kim5Kyoungbun Lee6Seung Seok Han7Department of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Pathology, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineDepartment of Pathology, Seoul National University College of MedicineDepartment of Internal Medicine, Seoul National University College of MedicineAbstract Background Henoch-Schönlein purpura nephritis (HSPN), a small-vessel vasculitis, shares renal pathological features with immunoglobulin A nephropathy. Oxford classification of immunoglobulin A nephropathy pathology has been updated to the MEST-C score, but its application in HSPN remains unresolved. Methods Two hundred and thirteen patients with biopsy-proven HSPN were retrieved from the Seoul National University Hospital between 2000 and 2017. Renal outcome risks (i.e., end-stage renal disease or doubling of serum creatinine) were evaluated according to MEST-C scores after stratification by age: 113 children aged < 18 years (9.2 ± 3.6 years) and 100 adults aged ≥18 years (38.6 ± 18.3 years). We pooled our data with four previous cohort studies in which MEST or MEST-C scores were described in detail. Results Twenty-one child (19%) and 16 adult (16%) patients reached the renal outcome during the median follow-up periods of 12 years and 13 years, respectively (maximum 19 years). In children, M1 and T1/T2 scores revealed worse renal outcomes than did M0 and T0 scores, respectively, whereas the T score was the only factor related to worse outcomes in adult patients after adjusting for multiple clinical and laboratory variables. The pooled data showed that M1, S1, and T1/T2 in children and E1 and T1/T2 in adults were correlated with poorer renal outcomes than those of their counterpart scores. Conclusions The Oxford classification MEST-C scores can predict long-term renal outcomes in patients with HSPN.https://doi.org/10.1186/s12882-020-1691-5End-stage renal diseaseHenoch-Schönlein purpura nephritisMEST-COxford classification |
| spellingShingle | Donghwan Yun Dong Ki Kim Kook-Hwan Oh Kwon Wook Joo Kyung Chul Moon Yon Su Kim Kyoungbun Lee Seung Seok Han MEST-C pathological score and long-term outcomes of child and adult patients with Henoch-Schönlein purpura nephritis BMC Nephrology End-stage renal disease Henoch-Schönlein purpura nephritis MEST-C Oxford classification |
| title | MEST-C pathological score and long-term outcomes of child and adult patients with Henoch-Schönlein purpura nephritis |
| title_full | MEST-C pathological score and long-term outcomes of child and adult patients with Henoch-Schönlein purpura nephritis |
| title_fullStr | MEST-C pathological score and long-term outcomes of child and adult patients with Henoch-Schönlein purpura nephritis |
| title_full_unstemmed | MEST-C pathological score and long-term outcomes of child and adult patients with Henoch-Schönlein purpura nephritis |
| title_short | MEST-C pathological score and long-term outcomes of child and adult patients with Henoch-Schönlein purpura nephritis |
| title_sort | mest c pathological score and long term outcomes of child and adult patients with henoch schonlein purpura nephritis |
| topic | End-stage renal disease Henoch-Schönlein purpura nephritis MEST-C Oxford classification |
| url | https://doi.org/10.1186/s12882-020-1691-5 |
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