MEST-C Pathological Score and Long-term Outcomes of Child and Adult Patients with Henoch-Schönlein Purpura Nephritis

Overview

Journal BMC Nephrol

Publisher Biomed Central

Specialty Nephrology

Date 2020 Feb 1

PMID 32000703

Citations 13

Authors

Donghwan Yun

Dong Ki Kim

Kook-Hwan Oh

Kwon Wook Joo

Kyung Chul Moon

Yon Su Kim

Kyoungbun Lee

Seung Seok Han

Affiliations

Soon will be listed here.

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.

Citing Articles

[Urinary protein and renal pathological features in children with immunoglobulin A vasculitis with nephritis and hypercoagulability].

Bai M, Yang X, Mei X, Li J, Yang Y, Huang Y Zhongguo Dang Dai Er Ke Za Zhi. 2024; 26(2):164-168.

PMID: 38436314 PMC: 10921882. DOI: 10.7499/j.issn.1008-8830.2309033.

Comparative study on clinicopathological features and prognosis of IgA vasculitis nephritis and IgA nephropathy in children.

Lv Y, Fu R, Peng X, Wang Y, Yin T, Deng Y BMC Pediatr. 2023; 23(1):423.

PMID: 37620917 PMC: 10464207. DOI: 10.1186/s12887-023-04243-3.

Bowman's capsule rupture and the Oxford MEST-C score in adult patients with Immunoglobulin a vasculitis nephritis: a single center experience.

Zhao Q, Duan T, Chen A, He L, Liu H, Yuan S Ann Med. 2023; 55(1):2215538.

PMID: 37246836 PMC: 10228299. DOI: 10.1080/07853890.2023.2215538.

A retrospective study on the characteristics of renal pathological grades in HSPN children with mild to moderate proteinuria.

Cao Y, Shen T, Li Y, Shuai L, Chen Q, Mo S Front Pediatr. 2022; 10:1029520.

PMID: 36467482 PMC: 9718029. DOI: 10.3389/fped.2022.1029520.

Semiquantitative classification (SQC) and Oxford classifications predict poor renal outcome better than The International Study of Kidney Disease in Children (ISKDC) and Haas in patients with IgAV nephritis: a multicenter study.

Kifer N, Bulimbasic S, Sestan M, Held M, Kifer D, Srsen S J Nephrol. 2022; 36(2):441-449.

PMID: 36447124 DOI: 10.1007/s40620-022-01509-4.

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