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FRI0444 Comparison of ACR (1990) and Eular/Printo/Pres (2010) Classification Criteria in Adult IGA Vasculitis
  1. A. Hočevar1,
  2. Ž. Rotar1,
  3. V. Jurčić2,
  4. A. Vizjak2,
  5. M. Tomšič1
  1. 1Department of Rheumatology, University Medical Centre Ljubljana
  2. 2Institute of Pathology, University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia

Abstract

Background In 2010 EULAR/PRINTO/PRES proposed new classification criteria for IgA vasculitis (IgAV).(1) In paediatric patient population these criteria have a higher diagnostic sensitivity than the older American College of Rheumatology (ACR) criteria.(1, 2) The performance of the new criteria has thus far not been evaluated in adult IgAV patients.

Objectives To compare the performance of the ACR and EULAR/PRINTO/PRES classification criteria in adult IgAV.

Methods Adult IgAV cases diagnosed using EULAR/PRINTO/PRES classification criteria at a tertiary rheumatology referral centre were critically reviewed in partially retrospective and partially prospective manner to assess whether these patients also fulfilled the ACR criteria.

Results Between January 1, 2010 and December 31, 2013 96 new adult IgAV cases (median age 63.4; interquartile range 40.8–77.3 years; 60.4% males; male to female ratio 1.53) were identified according to EULAR/PRINTO/PRES classification criteria. Purpura was present in all patients (generalized in 33/96 (34.3%), necrotic 43/96 (44.8%), bullous 9/96 (9.4%)) and was the only manifestation in 19 (19.8%) cases. Joints were involved (arthralgia or arthritis) in 44/96 (45.8%), gastrointestinal tract in 35/96 (36.4%), and kidneys in 56/96 (58.3%) cases. Lung, heart and testicular involvement was rare - one case of each. In 96/96 cases IgA deposits in vessel walls was documented on direct immunofluorescence staining. 91/96 of cases fulfilled both EULAR/PRINTO/PRES IgAV and ACR classification criteria. However, 5/96 patients (5.2%) fulfilled the EULAR/PRINTO/PRES classification criteria only. The characteristics of these patients are shown in Table 1.

Table 1.

IgAV cases fulfilling EULAR/PRINTO/PRES but not ACR classification criteria

Conclusions In an adult population the EULAR/PRINTO/PRES IgAV classification criteria have a higher sensitivity than the previously proposed ACR criteria, analogously to the findings in paediatric population.

References

  1. Ozen S, Pistorio A, Iusan SM, Bakkaloglu A, Herlin T, Brik R, et al. EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis 2010;69:798-806.

  2. Mills JA, Michel BA, Bloch DA, Calabrese LH, Hunder GG, Arend WP, et al. The American College of Rheumatology 1990 criteria for the classification of Henoch-Schönlein purpura. Arthritis Rheum 1990;33:1114–21.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.1906

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