title: Construction of a scoring system for predicting the risk of severe gastrointestinal involvement in Henoch-Schönlein Purpura.
abstract: OBJECTIVE
  To evaluate the parameters associated with significant gastrointestinal (GI) involvement in Henoch-Schönlein Purpura (HSP), and construct a scoring system for the identification of patients at high risk of gross blood in stools.
  
  
  METHODS
  Data for HSP patients hospitalized at each of seven institutes were retrospectively analyzed. Patients were divided into four groups according to the consequent severity of GI involvement. Identification of laboratory parameters at the time of admission were then used to differentiate the groups, and a scoring system to predict gross intestinal bleeding was constructed. Prognostic efficiency, correlation with the subsequent duration of abdominal pain, and association with manifestations excluding abdominal pain were also analyzed.
  
  
  RESULTS
  An analysis of variance (ANOVA) test showed significant intergroup differences in white blood cell (WBC) count, neutrophil count, serum albumin, potassium, plasma D-dimer and coagulation factor XIII activity. A scoring system consisting of these parameters showed a good prognostic value for gross intestinal bleeding in a receiver operating characteristic (ROC) analysis, and a cut-off value of 4 points showed a sensitivity of 90.0% and specificity of 80.6%. The score was also correlated with the duration of abdominal pain after admission. A significantly higher score (s) was observed in patients presenting with nephritis, although the predictive value was poor.
  
  
  CONCLUSIONS
  A scoring system consisting of generally available parameters was of use in predicting severe GI involvement in HSP patients. Although further study is needed, initial therapy in accordance with disease activity may be taken into consideration using this scoring system.
authors.affiliation: Department of Pediatrics, Abashiri Kosei Hospital, Abashiri, Hokkaido, Japan.
authors.forename: Tsunehisa
authors.initials: T
authors.lastname: Nagamori
authors.affiliation: Department of Pediatrics, Engaru Kosei Hospital, Hokkaido, Japan.
authors.forename: Hideharu
authors.initials: H
authors.lastname: Oka
authors.affiliation: Department of Pediatrics, Abashiri Kosei Hospital, Abashiri, Hokkaido, Japan.
authors.forename: Shin
authors.initials: S
authors.lastname: Koyano
authors.affiliation: Department of Pediatrics, Abashiri Kosei Hospital, Abashiri, Hokkaido, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Takahashi
authors.affiliation: Department of Pediatrics, Engaru Kosei Hospital, Hokkaido, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Oki
authors.affiliation: Department of Pediatrics, Abashiri Kosei Hospital, Abashiri, Hokkaido, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Department of Pediatrics, Abashiri Kosei Hospital, Abashiri, Hokkaido, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Murono
authors.affiliation: Department of Pediatrics, Engaru Kosei Hospital, Hokkaido, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Iseki
authors.affiliation: Department of Pediatrics, Abashiri Kosei Hospital, Abashiri, Hokkaido, Japan.
authors.forename: Ryou
authors.initials: R
authors.lastname: Takeguchi
authors.affiliation: Department of Pediatrics, Abashiri Kosei Hospital, Abashiri, Hokkaido, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Takeda
authors.affiliation: Department of Pediatrics, Engaru Kosei Hospital, Hokkaido, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Sato
authors.affiliation: Department of Pediatrics, Engaru Kosei Hospital, Hokkaido, Japan.
authors.forename: Rika
authors.initials: R
authors.lastname: Sugai
authors.affiliation: Department of Pediatrics, Abashiri Kosei Hospital, Abashiri, Hokkaido, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kitamura
authors.affiliation: Department of Pediatrics, Abashiri Kosei Hospital, Abashiri, Hokkaido, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Kajino
authors.affiliation: Department of Pediatrics, Engaru Kosei Hospital, Hokkaido, Japan.
authors.forename: Yurika
authors.initials: Y
authors.lastname: Miura
authors.affiliation: Department of Pediatrics, Engaru Kosei Hospital, Hokkaido, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Ishioka
authors.affiliation: Department of Pediatrics, Abashiri Kosei Hospital, Abashiri, Hokkaido, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Azuma