National recommendations for the management of children and young people with IgA vasculitis: a best available evidence, group agreement-based approach.

Autor:	Oni L; Department of Women's and Children's Health, University of Liverpool, Liverpool, UK louise.oni@liverpool.ac.uk.; Department of Paediatric Nephrology, Alder Hey Children's Hospital, Liverpool., Platt C; Bristol Renal Unit, Bristol Royal Hospital for Children, Bristol, UK., Marlais M; Department of Paediatric Nephrology, Great Ormond Street Hospital, London, UK., McCann L; Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool, UK., Barakat F; Kings College Hospital NHS Foundation Trust, London, UK., Hesseling M; Department of Paediatrics, Children's health Ireland, Dublin, Ireland., Cottis H; Department of Paediatrics, Royal Devon University Hospital, Devon, UK., Protheroe S; Department of Paediatric Gastroenterology, Birmingham Children's Hospital, Birmingham, UK., Haigh G; Department of Paediatrics, Betsi Cadwaladr Health Board, Wales, UK., Nott K; Department of Paediatric Rheumatology, Southampton Children's Hospital, Southampton, UK., Marro J; University of Liverpool Medical School, Liverpool, UK., King E; Woolton Medical Centre, Liverpool, UK., Kelly J; General Practice, Minchinhampton Surgery, Gloucestershire, UK., Sussens J; Nottingham Children's Hospital, Nottingham University Hospitals NHS Trust, Nottingham, UK., Mulvaney S; Department of Paediatric Emergency Medicine, Alder Hey Children's Hospital, Liverpool, UK., Whitby T; General Paediatrics, Alder Hey Children's Hospital, Liverpool, Merseyside, UK., Morgan I; Department of Paediatrics, Royal Hospital for Children, Glasgow, UK., Sharma A; Department of Paediatrics, Royal Hospital for Children, Glasgow, UK., Al-Jayyousi R; College of Medicine, Baghdad, Iraq., Cheung CK; University Hospitals of Leicester NHS Trust, Leicester, UK., Ng C; Sheffield Children's Hospital, Sheffield, UK., Lander AD; Surgery, Birmingham Children's Hospital, Birmingham, UK., Simmons W; Department of Paediatric Pathology, Alder Hey Children's Hospital, Liverpool, UK., Melling C; Department of Paediatric Surgery, Alder Hey Children's Hospital, Liverpool, UK., Grandison R; Patient Representative, -, UK., Treitl L; Patient Representative, -, UK., Salama AD; Department of Renal Medicine, UCL Centre for Kidney and Bladder Health, London, UK., Dudley J; Bristol Renal Unit, Bristol Royal Hospital for Children, Bristol, UK.
Jazyk:	angličtina
Zdroj:	Archives of disease in childhood [Arch Dis Child] 2024 Oct 18. Date of Electronic Publication: 2024 Oct 18.
DOI:	10.1136/archdischild-2024-327364
Abstrakt:	Objective: IgA vasculitis (IgAV) is the most frequently experienced subtype of vasculitis seen in children. Most children fully recover, however, complications including chronic kidney disease are recognised. The aim of this project was to use a best available evidence, group agreement, based approach to develop national recommendations for the initial management of IgAV and its associated complications. Methods: A fully representative multiprofessional guideline development group (GDG), consisting of 28 members, was formed and met monthly. Graded recommendations were generated using nationally accredited methods, which included a predefined scope, open consultation, systematic literature review, evidence appraisal, review of national or international guidelines and a period of open consultation. Audit measures and research priorities were incorporated. Results: The IgAV GDG met over a 14-month period. A total of 82 papers were relevant for evidence synthesis. For the initial management, four topic areas were identified with five key questions generating six graded recommendations related to classification, specialist referral and musculoskeletal involvement. For the associated complications, five topic areas with 12 key questions generated 15 graded recommendations covering nephritis, gastrointestinal and testicular involvement, atypical disease and follow-up. Open consultation feedback was incorporated. The guidelines were endorsed by the UK Kidney Association and Royal College of Paediatrics and Child Health and are available online. Conclusion: Despite IgAV being a rare disease with limited evidence, a national standardised approach to the clinical management for children and young people has been achieved. This should unite approaches to care and act as a foundation for improvement. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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