Clinical predictors of self-limited urinalysis abnormality in childhood Henoch-Schönlein purpura nephritis.
OBJECTIVE
The majority of patients (85-95%) with Henoch-Schönlein purpura nephritis (HSPN) suffer from a prolonged course of urinalysis abnormality. We sought to identify favourable prognostic factors predicting a self-limited urinalysis abnormality within 1 y.


METHODS
Fifty-eight HSPN patients admitted to the University Hospital between 1990 and 2003 were retrospectively analysed. Detailed information on clinical and laboratory manifestations on admission and sequential follow-up clinics were recorded. The chi2 or Fisher's exact test were used for univariate analysis, and multiple logistic regression was used for multivariate analysis.


RESULTS
The study cohort included 31 boys and 27 girls, with a mean age of onset of 8.0+/-4.3 y and a median follow-up duration of 5.9 y (range 1 to 25). Of 58 patients, 39 (67.3%) had a self-limited urinalysis abnormality within 1 y. On multivariate analysis, onset age less than 9 (p=0.038), low-grade proteinuria (p=0.044) and interval between purpura onset and renal manifestations less than 2 wk (p=0.005) predicted self-resolved urinalysis abnormality within 1 y. With two or more predictive factors, the sensitivity for short-term course was 84.6%, the specificity was 73.7%, and the positive predictive value was 84.8%.


CONCLUSIONS
A small number of variables were important for detecting a favourable short-term course of urinalysis abnormality.
Hung
Shuo-Hsun
SH
Department of Paediatrics, National Taiwan University Hospital, Taipei, Taiwan.
Yang
Yao-Hsu
YH
Lee
Chien-Chang
CC
Wang
Li-Chieh
LC
Lin
Yu-Tsan
YT
Chiang
Bor-Luen
BL
D000209:Acute-Phase Proteins / Q000378:metabolism; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications* / Q000175:diagnosis* / Q000378:metabolism; D007132:Immunoglobulin Isotypes / Q000097:blood; D007677:Kidney Function Tests; D008297:Male; D009393:Nephritis / Q000150:complications* / Q000175:diagnosis* / Q000378:metabolism; D010976:Platelet Count; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D016482:Urinalysis; D014570:Urologic Diseases / Q000209:etiology
D000209:Acute-Phase Proteins; D007132:Immunoglobulin Isotypes