The major adverse effects of azathioprine include liver toxicity and bone marrow suppression. flare-up after complete remission and discontinuation of all medications for at least 3 months. Corticosteroid dependence was defined by more than 6?weeks of daily oral corticosteroid intake. Refractory disease was defined as not achieving complete remission 6?months after disease onset. Statistical analysis was performed using R software (v3.6.0). Results There were 484 IgAV patients, with an onset age of 6.10 (4.72C8.58) (median (IQR)) years old. There were 234 (48.3%) patients 6?years old, 210 (43.4%) 6C12?years old, and 40 (8.3%) 12C18?years old. One hundred and CX-6258 HCl thirty (26.9%) patients had renal involvement, which was more frequent in older children ( 6?years old, 18.4%; 6C12?years old, 31.0%; 12C18?years old, 55.0%; valueImmunoglobulin A, Central nervous system, Peripheral nervous system, Gastrointestinal, Not available a Patients were grouped by onset age: 6 Y (years old), 6C12 Y ( ?6, 12?years old), and 12C18 Y ( ?12, ?18?years old) Renal involvement was noted in 130 (26.9%) patients, and it occurred more frequently in older children ( 6?years old, 18.4%; 6C12?years old, 31.0%; 12C18?years old, 55.0%; valueHemoglobin, Platelet, White blood cells, Platelet-to-lymphocyte ratio, Neutrophil-to-lymphocyte ratio, Immunoglobulin A, Antinuclear antibody, C-reactive protein a Patients were grouped by onset age: 6 Y (years old), 6C12 Y ( ?6, 12?years old), and 12C18 Y ( ?12, ?18?years old) Table 3 Adjusted laboratory parameters in pediatric IgA vasculitis patients in different onset age groups valueHemoglobin, White blood cells, Immunoglobulin A a Patients were grouped by onset age: 6 Y (years old), 6C12 Y ( ?6, 12?years old), and 12C18 Y ( ?12, ?18?years old) Medication The most commonly used medications were NSAIDs and CS, which were prescribed to 90.1 and 83.9% of the patients, respectively. Azathioprine (46.3%) was the most commonly prescribed DMARD, followed by cyclosporine (13.2%) and hydroxychloroquine (12.6%). Twenty patients received methylprednisolone mini-pulse or pulse therapy (15?mg/kg/day for 2?days, with a maximum of 500?mg/day; or 30?mg/kg/day for 3?days, with a maximum of 1000?mg/day). Three patients received intravenous immunoglobulin (1?g/kg/day for 2?days); two patients received cyclophosphamide pulse therapy for nephrotic syndrome; one patient received rituximab for refractory abdominal pain and arthralgia. The administrative rate of NSAIDs and CS among the three subgroups showed no significant difference. However, use of DMARDs was more frequent in children over 6?years old ( 6?years old, 36.4%; 6C12?years old, 60.9%; 12C18?years old, 71.4%; valueImmunoglobulin A, Corticosteroid, Non-steroidal anti-inflammatory drugs, Disease-modifying anti-rheumatic drugs a Patients were grouped by onset age: 6 Y (years old), 6C12 Y ( ?6, 12?years old), and 12C18 Y ( ?12, ?18?years old) b Other DMARDs included mesalazine, sulfasalazine, dapsone, colchicine, methotrexate, and mycophenolate mofetil Meanwhile, the cumulative CS dose (body weight adjusted Rabbit polyclonal to c-Myc equivalent dose of oral prednisolone) was significantly higher in the 12C18?years old group (median: 22.80?mg/kg, IQR: 13.05C52.65) compared CX-6258 HCl with patients 6?years old (median: 13.83?mg/kg, IQR: 3.89C29.17) (Fig.?1a) (valueCorticosteroid a Patients were grouped by onset age: 6 Y (years old), 6C12 Y ( ?6, 12?years old), and 12C18 Y ( ?12, ?18?years old) b Recurrence was defined as disease flare-up after complete remission and medication free for at least three months c CS dependence was defined as more than 6?weeks of daily oral CS intake d Refractory disease was defined as not CX-6258 HCl achieving complete remission 6?months after disease onset To further determine the major CX-6258 HCl factors in recurrence, refractory disease and CS dependence, we performed univariate logistic regressions. Significant factors by univariate analysis were then joined into multivariate logistic regressions. By multivariate analysis, renal involvement was associated with a 3.05-fold (95% CI, 1.42C6.49; em P /em ?=?0.004) increased odds of IgAV recurrence, a 20.51-fold (95% CI, 10.73C41.84; em P /em ? ?0.001) increased odds of refractory disease, and a 5.46-fold (95% CI, 2.96C10.22; em P /em ? ?0.001) increased odds of developing CS dependence compared to those without renal involvement (see Additional file 1: Table S6-S8). Meanwhile, an increase of onset age by 1 year was associated with a 1.27-fold (95% CI, 1.16C1.39; P? ?0.001) increased odds in developing refractory disease and a 1.12-fold (95% CI,.
