European consensus-based recommendations for diagnosis and treatment of immunoglobulin A vasculitis-the SHARE initiative
Jazyk angličtina Země Anglie, Velká Británie Médium print
Typ dokumentu konsensus - konference, časopisecké články, směrnice pro lékařskou praxi, práce podpořená grantem
PubMed
30879080
DOI
10.1093/rheumatology/kez041
PII: 5382174
Knihovny.cz E-zdroje
- Klíčová slova
- IgA vasculitis (Henoch–Schönlein purpura), childhood/paediatric, diagnosis, management, recommendations, systemic vasculitis,
- MeSH
- analgezie metody MeSH
- biopsie MeSH
- dítě MeSH
- gastrointestinální nemoci diagnóza etiologie MeSH
- glukokortikoidy terapeutické užití MeSH
- IgA nefropatie diagnóza farmakoterapie etiologie patologie MeSH
- IgA vaskulitida komplikace diagnóza farmakoterapie patologie MeSH
- imunoglobulin A analýza MeSH
- inhibitory ACE terapeutické užití MeSH
- kůže patologie MeSH
- ledviny patologie MeSH
- lidé MeSH
- medicína založená na důkazech metody MeSH
- stupeň závažnosti nemoci MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- konsensus - konference MeSH
- práce podpořená grantem MeSH
- směrnice pro lékařskou praxi MeSH
- Názvy látek
- glukokortikoidy MeSH
- imunoglobulin A MeSH
- inhibitory ACE MeSH
OBJECTIVES: IgA vasculitis (IgAV, formerly known as Henoch-Schönlein purpura) is the most common cause of systemic vasculitis in childhood. To date, there are no internationally agreed, evidence-based guidelines concerning the appropriate diagnosis and treatment of IgAV in children. Accordingly, treatment regimens differ widely. The European initiative SHARE (Single Hub and Access point for paediatric Rheumatology in Europe) aims to optimize care for children with rheumatic diseases. The aim therefore was to provide internationally agreed consensus recommendations for diagnosis and treatment for children with IgAV. METHODS: Recommendations were developed by a consensus process in accordance with the EULAR standard operating procedures. An extensive systematic literature review was performed, and evidence-based recommendations were extrapolated from the included papers. These were evaluated by a panel of 16 international experts via online surveys and subsequent consensus meeting, using nominal group technique. Recommendations were accepted when ⩾80% of experts agreed. RESULTS: In total, 7 recommendations for diagnosis and 19 for treatment of paediatric IgAV were accepted. Diagnostic recommendations included: appropriate use of skin and renal biopsy, renal work-up and imaging. Treatment recommendations included: the importance of appropriate analgesia and angiotensin-converting enzyme inhibitor use and non-renal indications for CS use, as well as a structured approach to treating IgAV nephritis, including appropriate use of CS and second-line agents in mild, moderate and severe disease along with use of angiotensin-converting enzyme inhibitors and maintenance therapy. CONCLUSION: The SHARE initiative provides international, evidence-based recommendations for the diagnosis and treatment of IgAV that will facilitate improvement and uniformity of care.
Department of Paediatric Rheumatology Alder Hey Children's NHS Foundation Trust Liverpool UK
Department of Paediatric Rheumatology Bicêtre University Hospital Paris France
Department of Paediatric Rheumatology University Children's Hospital Ljubljana Ljubljana Slovenia
Department of Paediatrics Hacettepe University Ankara Turkey
Gaslini Children's Hospital Genoa Italy
General University Hospital and 1 Faculty of Medicine Charles University Prague Czech Republic
Hospital for Children and Adolescents University of Helsinki Helsinki Finland
Meir Medical Centre Tel Aviv University Tel Aviv Israel
Necker Hospital Assistance Publique Hôpitaux de Paris Paris France
Sophia Children's Hospital Erasmus University Medical Centre Rotterdam The Netherlands
The Hospital for Sick Children University of Toronto Toronto Canada
Wilhelmina Children's Hospital University Medical Center Utrecht
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