ESPN 53rd Annual Meeting

ESPN 2021


 
Outcome of children with IgA vasculitis with nephritis treated with steroids: a match control study.
JEAN-DANIEL DELBET 1 STEPHANIE CLAVE 5 JULIEN HOGAN 2 OLIVIA BOYER 3 JEROME HARAMBAT 4 cyrielle parmentier 1 TIM ULINSKI 1

1- PEDIATRIC NEPHROLOGY, ARMAND TROUSSEAU HOSPITAL, APHP, PARIS, FRANCE
2- PEDIATRIC NEPHROLOGY, ROBERT DEBRé HOSPITAL, APHP, PARIS, FRANCE
3- PEDIATRIC NEPHROLOGY, NECKER ENFANTS MALADES, APHP, PARIS, FRANCE
4- PEDIATRIC NEPHROLOGY, CHU DE BORDEAUX, FRANCE
5- Pediatric Nephrology, CHU de Marseille, France
 
Introduction:

 

IgA vasculitis (IgAV) is the most common vasculitis in children. IgAV long-term prognosis depends on kidney involvement or IgA vasculitis with nephritis (IgAVN). Up to now, steroid treatment (oral steroids or methylprednisolone pulses) have not proven to be formally efficient. The objective of our study is to assess steroid impact on IgAVN prognosis.

Material and methods:

 

All children with IgAVN diagnosed between 2000 and 2019 in French paediatric nephrology units were retrospectively included. The outcomes of patients treated with steroids were compared with those of a control group of untreated patients matched for age, sex, proteinuria, eGFR and histological features. The primary endpoint was IgAVN remission defined as a proteinuria <200 mg/L without renal failure.

Results:

 

359 patients with IgAVN were included with a median follow-up time of 249 days (43-809). 108 (30%) patients received oral steroids alone and 207 (51%) patients received three methylprednisolone pulses followed by oral corticosteroids, 44 patients (12.5%) did not receive steroids. Thirty-four children treated with oral steroids alone were compared with 34 matched control patients who did not receive steroid. IgAVN remission proportion was not different between these two groups: 76% versus 77% respectively. Ninety children treated with oral steroids alone were compared with 180 matched patients treated with three methylprednisolone pulses followed by oral corticosteroids. IgAVN remission proportion was not different between these two groups: 76% versus 73% respectively.

Conclusions:

 

The benefit of oral steroids alone and methylprednisolone pulses could not be established based on our findings. Randomized controlled trials are thus required to determine the efficacy of stroids in IgAV with nephritis.