scholarly journals Enthesitis Related Arthritis in a Longitudinal Southeast Asian Registry: High Prevalence of HLA-B27, Different Sacroiliitis Risk Factors and Less Common Drug-Free Remission

2021 ◽  
Vol 10 (4) ◽  
pp. 568
Author(s):  
Thaschawee Arkachaisri ◽  
Kai Liang Teh ◽  
Yun Xin Book ◽  
Sook Fun Hoh ◽  
Xiaocong Gao ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Cox Regression ◽  
Age At Onset ◽  
Human Leukocyte ◽  
Common Disease ◽  
Hla B27 ◽  
Significance Level ◽  
Enthesitis Related Arthritis ◽  
Joint Deformity ◽  
Kaplan Meier

Objective. To describe the clinical characteristics, predictors and treatment of children with Enthesitis Related Arthritis (ERA) in a Singapore longitudinal cohort over 11 years. Methods. ERA patients were recruited from our registry (2009–2019). Nonparametric descriptive statistics including median (interquartile range, IQR) were used to describe data. Kaplan–Meier survival and logistic/Cox regression analyses were used to estimate the probabilities and determine predictors of clinical variables, respectively. The significance level was set at <0.05. Results. One hundred and forty-six ERA patients (87% male, 82% Chinese) were included. Median onset age was 11.9 years (IQR 9.4–14.0) and median disease duration was 4.9 years (IQR 2.6–8.3). Family history of Human Leukocyte Antigen (HLA)-B27 associated diseases was positive in 7.5%. Acute uveitis occurred in 3.4%. Oligoarthritis was present in 89.7%. Hip, knee and ankle joints were among the most common joints involved. One-fourth had enthesitis at diagnosis (Achilles tendon entheses, 82.9%). Sacroiliitis occurred in 61%. Probabilities of sacroiliitis development were 0.364, 0.448 and 0.578 at 1, 2 and 5 years after onset, respectively. Negative HLA-B27, female, older age at onset and hip arthritis at diagnosis were associated with shorter time for sacroiliitis development (p = 0.001–0.049). Methotrexate (MTX) remained the most common disease modifying anti-rheumatic drug (DMARD) used (77.4%). However, 77.9% required anti-TNF (aTNF) therapy secondary to MTX failure. Among MTX-treated sacroiliitis patients, 85.3% failed, requiring aTNF, as compared to 63.2%patients without axial disease. Longer duration to diagnosis (p = 0.038) and MTX use (p = 0.007) predicted aTNF therapy. None had joint deformity. Conclusions. This study underscores differences in ERA clinical characteristics, predictors and treatment responses. Our ERA population had many unique findings but good functional outcomes.

scholarly journals Effect of MHC Linked 7-Gene Signature on Delayed Hepatocellular Carcinoma Recurrence

2021 ◽  
Vol 11 (11) ◽  
pp. 1129
Author(s):  
Fomaz Tariq ◽  
Walizeb Khan ◽  
Washaakh Ahmad ◽  
Syeda Kiran Riaz ◽  
Mahvish Khan ◽  
...  
Keyword(s):  
Cox Regression ◽  
Human Leukocyte ◽  
Gene Interaction ◽  
Gene Signature ◽  
Leukocyte Antigens ◽  
Kaplan Meier ◽  
Hepatocellular Carcinoma Recurrence ◽  
Patient Prognosis ◽  
Transcriptomic Level ◽  
Immune Related Genes

Dysregulated immune response significantly affects hepatocellular carcinoma’s (HCC) prognosis. Human Leukocyte Antigens are key in devising immune responses against HCC. Here, we investigated how HLAs modulate HCC development at the transcriptomic level. RNA-seq data of 576 patients from two independent cohorts was retrieved. The clinicopathological relevance of all HLA genes was investigated using Fisher-Exact, correlation, and Kaplan–Meier and cox regression survival tests. Clustering of ~800 immune-related genes against HLAs was completed using a ward-agglomerative method. Networks were generated using 40 HLA associated unique genes and hub genes were investigated. HLAs including HLA-DMA, HLA-DMB, HLA-DOA and HLA-DRB6 were associated with delayed recurrence in both discovery (204 HCC cases) and validation (372 HCC cases) cohorts. Clustering analyses revealed 40 genes associated with these four HLAs in both cohorts. A set of seven genes (NCF4, TYROBP, LCP2, ZAP70, PTPRC, FYN and WAS) was found co-expressed at gene–gene interaction level in both cohorts. Furthermore, survival analysis revealed seven HLA-linked genes as predictors of delayed recurrence. Multivariate analysis also predicted that mean expression of 7-gene is an independent predictor of delayed recurrence in both cohorts. We conclude that the expression of 7-gene signature may lead to improved patient prognosis. Further studies are required for consideration in clinical practice.

scholarly journals Micronutrient status in middle childhood and age at menarche: results from the Bogotá School Children Cohort

2017 ◽  
Vol 118 (12) ◽  
pp. 1097-1105 ◽  
Author(s):  
Eduardo Villamor ◽  
Constanza Marín ◽  
Mercedes Mora-Plazas ◽  
Henry Oliveros
Keyword(s):  
Middle Childhood ◽  
Cox Regression ◽  
Age At Onset ◽  
Age At Menarche ◽  
Reactive Protein ◽  
Kaplan Meier ◽  
Micronutrient Status ◽  
Hazard Ratios ◽  
Erythrocyte Folate ◽  
Linear Manner

AbstractChildhood intake of animal foods is associated with age at first menstrual period (menarche). It is unknown whether the micronutrients present in these foods could explain this association. Our objective was to investigate the associations of micronutrient status biomarkers in middle childhood with age at menarche. We quantified circulating Hb, ferritin, mean corpuscular volume, Zn, vitamin B12, erythrocyte folate and retinol in 1464 pre-menarcheal girls aged 5–12 years in Bogotá, Colombia, and followed them for a median 5·7 years for the occurrence and date of menarche. We estimated median age at menarche and hazard ratios (HR) with 95 % CI by levels of each biomarker with use of Kaplan–Meier survival probabilities and Cox regression, respectively. Median age at menarche was 12·4 years. Middle childhood Hb was inversely related to age at menarche whereas plasma ferritin was positively associated with this outcome in a linear manner. HR of menarche for every 1sdof Hb (11 g/l) and ferritin (23·2 µg/l) were 1·11 (95 % CI 1·04, 1·18;P=0·001) and 0·94 (95 % CI 0·88, 0·99;P=0·02), respectively, after adjustment for baseline age, C-reactive protein concentration, maternal age at menarche and parity and socioeconomic status. The association with ferritin was stronger in girls aged 9–10 years at baseline. Additional adjustment for baseline height- and BMI-for-age did not change the results. We conclude that higher Fe status in middle childhood is related to later age at menarche whereas Hb concentrations are inversely associated with age at onset of menses.

The cortical damage, early relapses, and onset of the progressive phase in multiple sclerosis

Neurology ◽  
2018 ◽  
Vol 90 (24) ◽  
pp. e2107-e2118 ◽  
Author(s):  
Antonio Scalfari ◽  
Chiara Romualdi ◽  
Richard S. Nicholas ◽  
Miriam Mattoscio ◽  
Roberta Magliozzi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cox Regression ◽  
Age At Onset ◽  
Cortical Atrophy ◽  
Clinical Activity ◽  
Cortical Damage ◽  
Clinical Onset ◽  
Kaplan Meier ◽  
Relapsing Remitting ◽  
Risk Of Progression

ObjectiveTo investigate the relationship among cortical radiologic changes, the number of early relapses (ERs), and the long-term course of multiple sclerosis (MS).MethodsIn this cohort study, we assessed the number of cortical lesions (CLs) and white matter (WM) lesions and the cortical thickness (Cth) at clinical onset and after 7.9 mean years among 219 patients with relapsing remitting (RR) MS with 1 (Low-ER), 2 (Mid-ER), and ≥3 (High-ER) ERs during the first 2 years. Kaplan-Meier and Cox regression analyses investigated early factors influencing the risk of secondary progressive (SP) MS.ResultsFifty-nine patients (27%) converted to SPMS in 6.1 mean years. A larger number of CLs at onset predicted a higher risk of SPMS (hazard ratio [HR] 2.16, 4.79, and 12.3 for 2, 5, and 7 CLs, respectively, p < 0.001) and shorter latency to progression. The High-ER compared to the Low-ER and Mid-ER groups had a larger volume of WM lesions and CLs at onset, accrued more CLs, experienced more severe cortical atrophy over time, and entered the SP phase more rapidly. In the multivariate model, older age at onset (HR 1.97, p < 0.001), a larger baseline CL (HR 2.21, p = 0.005) and WM lesion (HR 1.32, p = 0.03) volume, early changes of global Cth (HR 1.36, p = 0.03), and ≥3 ERs (HR 6.08, p < 0.001) independently predicted a higher probability of SP.ConclusionsExtensive cortical damage at onset is associated with florid inflammatory clinical activity and predisposes to a rapid occurrence of the progressive phase. Age at onset, the number of early attacks, and the extent of baseline focal cortical damage can identify groups at high risk of progression who may benefit from more active therapy.

Does chemotherapy work in reversal of malignant obstruction due to gastric cancer?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21676-e21676
Author(s):  
Vanessa Montes Santos ◽  
Renata Gondim Meira Velame Azevedo ◽  
Rossana Veronica Mendoza Lopez ◽  
Paulo Marcelo Hoff ◽  
Jorge Sabbaga ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Overall Survival ◽  
Cox Regression ◽  
Metastatic Gastric Cancer ◽  
Rank Test ◽  
Anticholinergic Drugs ◽  
Significance Level ◽  
Malignant Obstruction ◽  
Kaplan Meier ◽  
Clinical Measures

e21676 Background: Malignant obstruction (MO) is a common complication in patients with gastric cancer. Although palliative chemotherapy has already shown beneficial for overall survival in advanced cases, its value for MO reversal is still unknown. Methods: Inthis retrospective study we analyzed all consecutive patients with metastatic gastric cancer admitted with MO at the Instituto do Câncer do Estado de São Paulo (ICESP) from 2008 to 2016. The primary and secondary endpoints were overall survival and obstruction reversal rate respectively. Clinical measures other than chemotherapy and alimentary pause included the use of octreotide 0.1 mg, 3 times a day, steroids, antiemetics and anticholinergic drugs. Survival curves were calculated by Kaplan-Meier and log-rank test was used to compare them. The Cox regression model was used to evaluate risk factors for overall survival and the hazard ratio (HR) was calculated with its respective 95% confidence intervals. The analysis was performed in SPSS v.18 for Windows statistical software, and the significance level was 5%. Results: One hundred and eighteen(118)patients were included. Median overall survival was 11.2 months and survival time after the MO was 3.6 months for the whole group. Median time of use of octreotide was 3 days. Reversal of obstruction was seen in 16 of 36 patients (38.4%) in which chemotherapy was used and only in 22 of the 92 patients (24%) treated with exclusive clinical measures. In spite of these figures a significant better overall survival (p 0.002) was achieved in the group of patients that reached obstruction reversal without chemotherapy (13.6 months vs. 11.6 months for the clinical treatment group). Conclusions: This study suggests that chemotherapy even when reversing MO, has no impact in patients overall survival. These finding is particularly relevant for cost contingency in settings with limited resources. .

scholarly journals Breastfeeding: what changed after a decade?

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Áurea Tamami Minagawa Toryiama ◽  
Elizabeth Fujimori ◽  
Claudia Nery Teixeira Palombo ◽  
Luciane Simões Duarte ◽  
Ana Luiza Vilela Borges ◽  
...  
Keyword(s):  
Median Duration ◽  
Cox Regression ◽  
Small City ◽  
Cross Sectional ◽  
Significance Level ◽  
Paulo State ◽  
Kaplan Meier ◽  
Duration Of Breastfeeding ◽  
Method Analysis ◽  
Pacifier Use

ABSTRACT Objective: to analyze the changes in prevalence, median duration and correlates of breastfeeding in a small city in São Paulo state, Brazil. Method: analysis of two cross-sectional studies, conducted at intervals of one decade, with 261 and 302 children younger than two years, respectively. We used Kaplan-Meier survival analysis for calculation of the median duration of breastfeeding, and Cox regression for correlates analysis, with significance level of 5%. Results: an increase of 33.4% in the prevalence of exclusive breastfeeding and 20.9% in breastfeeding was identified. Regarding the latter, the median duration increased from 7.2 to 12 months. In the most recent study, the median duration was lower in first-born children who used pacifiers, and it was not associated with breastfeeding incentive actions. Conclusions: advances in the prevalence and duration of breastfeeding were observed during the 10 year-period, however, pacifier use still remains associated to a shorter median duration of breastfeeding. Our findings contribute to highlighting the need for intensification of nursing actions in the promotion of breastfeeding, and discouragement regarding the use of pacifiers.

scholarly journals AB0668 CLINICAL CHARACTERISTICS OF RADIOGRAPHIC AND NON RADIOGRAPHIC AXIAL SPONDYLOARTHRITIS IN A GROUP OF TUNISIAN SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1629.1-1629
Author(s):  
K. Ben Abdelghani ◽  
Y. Gzam ◽  
A. Fazaa ◽  
S. Miladi ◽  
K. Ouenniche ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Characteristics ◽  
Axial Spondyloarthritis ◽  
Age At Onset ◽  
Diagnostic Delay ◽  
Hla B27 ◽  
The Family ◽  
History Of ◽  
The Mean ◽  
Predominantly Female

Background:In the literature, non radiographic axial Spondyloarthritis (nr-SpA) is predominantly female with a shorter period of evolution and similar peripheral manifestations to radiographic axial spondyloarthritis (r-SpA). However, we do not have Tunisian studies comparing the two groups of axial spondyloarthritis (ax-SpA).Objectives:The aim of this study was to assess the epidemiological and clinical differences between nr-SpA and r-SpA in a group of Tunisian ax-SpA.Methods:Two hundred patients with ax-SpA (ASAS 2009 criteria) were retrospectively included and classified as r-Spa characterized by the presence of radiographic sacroiliitis and nr-SpA defined by the presence sacroiliitis only on MRI or HLA B27 antigen with other clinical features. The different demographic and clinical parameters were compared between the nr-SpA and r-SpA groups.Results:One hundred thirty-eight men and 62 women were included with a sex ratio of 2,2. The mean age was 43,3 ± 11,2 years and the mean period of evolution was 10,7 ± 8,4 years. The patients were divided to r-SpA in 80% of cases (n = 160) and nr-SpA in 20% of cases (n = 40).Women were more present in the nr-SpA group with 47,5% of women versus 26.8% of women in the r-SpA group (p = 0,01). The patients with nr-SpA were younger with a mean age of 39,4 ± 13,4 years versus 44,3 ± 10,4 years in patients with r-SpA (p = 0,03). The mean period of evolution was shorter in nr-SpA group (5,8 ± 4,9 years vs 11.9 ± 8.5; p <0.001). The family history of SpA was more frequent in nr-SpA group (17.5% vs 4.3%, p = 0.004). Arthritis were more frequent in nr-SpA (42.5% vs 13.7%; p <0.0001). Similarly, enthesitis were more frequent in nr-SpA group (45% vs 15.6%; p <0.0001).No statistically significant differences were found in the following parameters: age at onset of symptoms, diagnostic delay, HLA B-27 antigen and dactylitis.Conclusion:The clinical features were different in the 2 groups of ax-SpA: Patients with nr-SpA were more female and had more peripheral manifestations while patients with r-SpA were older and with longer period of evolution.References:[1]de Winter JJ, et al. Arthritis Res Ther 2016; 18:196[2]Malaviya AN, et al. Int J Rheum Dis 2015; 18(7):736–41Disclosure of Interests:None declared

scholarly journals The Infratentorial Localization of Brain Metastases May Correlate with Specific Clinical Characteristics and Portend Worse Outcomes Based on Voxel-Wise Mapping

Cancers ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 324
Author(s):  
Zhangqi Dou ◽  
Jiawei Wu ◽  
Hemmings Wu ◽  
Qian Yu ◽  
Feng Yan ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Clinical Characteristics ◽  
Cox Regression ◽  
Whole Brain Radiotherapy ◽  
Ki 67 ◽  
Brain Radiotherapy ◽  
Kaplan Meier ◽  
Radiotherapy Alone ◽  
Prognostic Prediction ◽  
Occipital Lobes

The infratentorial regions are vulnerable to develop brain metastases (BMs). However, the associations between the infratentorial localization of BMs and clinical characteristics remained unclear. We retrospectively studied 1102 patients with 4365 BM lesions. Voxel-wise mapping of MRI was applied to construct the tumor frequency heatmaps after normalization and segmentation. The analysis of differential involvement (ADIFFI) was further used to obtain statistically significant clusters. Kaplan-Meier method and Cox regression were used to analyze the prognosis. The parietal, insular and left occipital lobes, and cerebellum were vulnerable to BMs with high relative metastatic risks. Infratentorial areas were site-specifically affected by the lung, breast, and colorectal cancer BMs, but inversely avoided by melanoma BMs. Significant infratentorial clusters were associated with young age, male sex, lung neuroendocrine and squamous cell carcinomas, high expression of Ki-67 of primaries and BMs, and patients with poorer prognosis. Inferior OS was observed in patients with ≥3 BMs and those who received whole-brain radiotherapy alone. Infratentorial involvement of BMs was an independent risk factor of poor prognosis for patients who received surgery (p = 0.023, hazard ratio = 1.473, 95% confidence interval = 1.055–2.058). The current study may add valuable clinical recognition of BMs and provide references for BMs diagnosis, treatment evaluation, and prognostic prediction.

scholarly journals Thyroid Complications Negatively Affect Therapeutic Response and Survival in Waldenstrom Macroglobulinaemia/ Lymphoplasmacytoid Lymphoma

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4513-4513
Author(s):  
Xinting Hu ◽  
Hua Wang ◽  
Hongzhi Xu ◽  
Xin Liu ◽  
Ying Li ◽  
...  
Keyword(s):  
Gene Expression ◽  
Clinical Characteristics ◽  
Cox Regression ◽  
Statistical Significance ◽  
Progression Free Survival ◽  
Chi Square ◽  
Free Survival ◽  
Kaplan Meier ◽  
Chi Square Test

Abstract Introduction: Waldenström macroglobulinaemia/ Lymphoplasmacytoid lymphoma (WM/LPL) is a rare lymphoproliferative neoplasm characterized by small B lymphocytes proliferation. Abnormalities of thyroid hormones are common in clinical courses. Yet, the role of thyroid complications has not been explored in WM/LPL. Hence, the aim of this study was to investigate the clinical significance of thyroid complications in WM/LPL. Methods: 105 clinically diagnostic WM/LPL patients from Shandong Provincial Hospital were enrolled with informed consents. Baseline and clinical data concerning sex, age, International Staging System Waldenstrom Macroglobulinemia (ISSWM) score et al were collected. Chi-square test was used for comparison of clinical characteristics. The Kaplan-Meier method was used for analysis of survival outcomes. Cox regression analyses were utilized to identify prognostic-related key factors associated with overall survival (OS) and progression-free survival (PFS) in WM/LPL patients. Microarray datasets GSE6691 were obtained from Gene Expression Omnibus. Results: Over the 105 WM/LPL patients, the median overall survival (OS) was not reached and median progression-free survival (PFS) was 96 months (Figure 1A, 1B). Patients classified as complete response (CR)/ partial response (PR)/ stable disease (SD), showed better OS and PFS than patients with progression disease (PD) (Figure 1C, D). There were 13.3% of enrolled patients with mixed thyroid complications. The results of Chi-square test showed that thyroid complications were significantly associated with reduced IgM level (p=0.036) and elevated β2-macroglobulin (p=0.032). Moreover, patients without thyroid comorbidities were more likely to get overall response (CR+PR) to the first-line treatment (p=0.004). Kaplan-Meier curves showed patients with thyroid complications had significantly shorter OS (p=0.02) and PFS (p&lt;0.001) versus those without thyroid complications (Figure 1E, F). In the univariate Cox regression model, age (p=0.022), ISSWM score (p=0.014) and thyroid complications (p&lt;0.001) were significantly associated with an increased risk of progression developed. Subsequent multivariate analysis showed the presence of thyroid complications was an independent prognostic indicator for PFS in WM/LPL patients (p=0.03). However, there was no statistical significance of thyroid complications in OS. Microarray dataset analysis was conducted to further investigate the role of thyroid-related genes in WM/LPL patients. A network of interactions among thyroid-related genes and critical factors in WM/LPL, including MYD88 and CXCR4, was shown in Figure 1G. Correlations were statistically significant between SLC5A5 (p&lt;0.05), TG (p&lt;0.01), TPO (p&lt;0.01) and CXCR4 by Spearman correlation analysis (Figure 1H, I). In addition, differential gene expression analysis between the WM and normal lymphocytes was assessed (Figure 1J). Thyroid-related genes with statistical significance were annotated in the volcano plots (Figure 1K). Enrichment analysis indicated that differential genes were involving in PI3K-Akt signaling pathway and response to peptide hormone (Figure 1L). Moreover, five of them reached statistical significance, illuminating the potential importance of thyroid-related genes in WM/LPL (Figure 1M). Conclusion: Taken together, the present study was the first investigation on the role of thyroid complications in WM/LPL. Patients with thyroid complications showed worse clinical characteristics and conferred independent prognostic significance. The primary strength of this study is that it provides robust real-world evidence on the prognostic role of thyroid complications, highlighting the need to monitor and appropriately manage WM/LPL patients with thyroid complications in medical admissions. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals Low high-density lipoprotein level is correlated with the severity of COVID-19 patients

2020 ◽  
Author(s):  
Guyi Wang ◽  
Quan Zhang ◽  
Haiyun Dong ◽  
Chenfang Wu ◽  
Fang Wu ◽  
...  
Keyword(s):  
High Density Lipoprotein ◽  
Clinical Characteristics ◽  
Cox Regression ◽  
Density Lipoprotein ◽  
High Density ◽  
Treatment Center ◽  
High Density Lipoproteins ◽  
Reactive Protein ◽  
Kaplan Meier ◽  
Low Hdl

Abstract Background The aim of the present study was to describe the clinical characteristics of patients with different levels of high-density lipoproteins (HDLs) and analyze the correlation between HDL levels and prognosis of coronavirus disease 2019 (COVID-19) patients. Methods In the clinical retrospective analysis, a total of 228 adult COVID-19 patients admitted to Public Health Treatment Center of Changsha, China from January 17 to March 14, 2020 were enrolled. Median with interquartile range and Mann-Whitney test were used to depict and analyze the clinical characteristics of patients. The Kaplan-Meier (KM) curve and cox regression were adopted to analyze the association between HDLs and severe events of COVID-19 patients. Results Median levels of high-density lipoprotein cholesterol (HDL-C) in adult COVID-19 patients were below normal range. Compared with patients with high HDL-C, patients with low HDL-C showed higher proportion of male (69.6% vs 45.6%, P = 0.004), higher levels of C-reactive protein (CRP) (median, 27.83 vs 12.56 mg/L, P = 0.000) and alanine aminotransferase (ALT) (median, 21.49 vs 18.81 U/L, P = 0.044), as well as higher proportion of severe events (37.0% vs 14.8%, P = 0.001). Moreover, they presented a higher risk of developing severe events compared with those with high HDL-C (Log Rank P < 0.001, Fig. 1). After adjusting for age, gender and underlying diseases, patients with low HDL-C still had elevated possibility of developing to severe cases than those with high HDL-C (HR 2.852, 95% CI 1.505–5.407, P = 0.001). Conclusions HDL-C level decreased in COVID-19 adult patients, and low HDL-C in COVID-19 patients was correlated with a higher risk of developing severe events.

scholarly journals Clinical and prognostic significance of PMN in children with glomerular C1q deposition

2020 ◽  
Author(s):  
Ren Wang ◽  
Meiqiu Wang ◽  
Zhengkun Xia ◽  
Chunlin Gao ◽  
Zhuo Shi ◽  
...  
Keyword(s):  
Regression Analysis ◽  
Renal Dysfunction ◽  
Cox Regression ◽  
Age At Onset ◽  
Prognostic Significance ◽  
Control Group ◽  
Cox Regression Analysis ◽  
Pathological Characteristics ◽  
Kaplan Meier ◽  
Renal Prognosis

Abstract Background Currently, studies to data in MN are consistent with complement activation has an essential role in mediating renal injury, and the LP is considered to be the principal pathway in PMN. CP activation initiated by C1q which deposits are suggestive of SMN. However, C1q deposition together with IgG and C3 granular deposit is found in many cases of PMN. Currently, the clinical and prognostic significance of C1q deposition in PMN is unclear. Therefore, we conduct this single-center research to explore the clinical and prognostic significance of C1q deposition in children with PMN. Method: 73 patients with C1q deposition were enrolled in this study. According to the “Case-control matching principle”, 73 patients without C1q deposition during the same period of the renal biopsy were selected as a control group. The clinical and pathological characteristics, treatment response, and long-term renal prognosis were compared between patients with and without C1q deposition. Result A total of 146 pediatric patients with PMN included with 86 men(58.9%) and 60 women (41.1%). The median age at onset was 15.0 (14.0—16.0) years. During an average follow-up of 52.4 ± 35.6 months, 8 patients (5.5%) progressed ESKD, 12 (8.2%) patients developed ESRD or renal dysfunction. The frequency of glomerular C4 deposits in the C1q deposits group was significantly higher than no C1q deposits group (34.2% vs 5.5%, p = 0.000). There were no other distinct differences in clinical and pathological characteristics between the two groups. Glomerular IgG subclasses were available in 79 patients, there was no difference in the glomerular IgG subclass distribution between the two groups (p IgG1=0.468,p IgG2=1.000༌p IgG3=0.988༌p IgG4=0.216). The Kaplan-Meier survival analysis found that there was no difference in the renal survival of ESRD (p = 0.415) and a combined event of ESRD and/or renal dysfunction (p = 0.214) between the two groups. The logistic regression analysis (p = 0.553) and Cox regression analysis (p = 0.618) revealed that C1q deposition failed to associate with renal dysfunction. Conclusion The CP does occur in some patients of PMN. However, it may be unrelated to the progression of the disease.

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