Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

This tool helps assess if someone meets the European League Against Rheumatism (EULAR), Pediatric Rheumatology International Trials Organization (PRINTO), and Pediatric Rheumatology European Society (PRES) criteria for Henoch-Schönlein purpura (HSP), a condition characterized by a small-vessel vasculitis. To determine this, you consider specific clinical signs and symptoms:

Inputs entail selecting from these criteria:

- Purpura or petechiae predominantly on the lower limbs, which is not linked to thrombocytopenia
- Sudden onset of severe abdominal pain, possibly with intussusception or gastrointestinal bleeding
- Biopsy indicating leucocytoclastic vasculitis or glomerulonephritis with IgA dominance
- Sudden onset arthritis, where there is joint swelling or pain limiting motion
- Sudden onset arthralgia, where there is joint pain but no swelling or motion restriction
- Proteinuria surpassing 0.3 g/24 hours or a specified albumin/creatinine ratio in a morning urine spot test
- Hematuria or red blood cell casts identified through urinary analysis 

The computation follows this logic:

- Confirm if purpura or petechiae with lower limb predominance is present.
- Check for at least one additional symptom or finding from the other criteria indications.

To meet the criteria for HSP, the individual must have purpura or petechiae primarily on the lower limbs and at least one other clinical sign from the list. If both are present, it concludes with "Meets criteria for Henoch-Schönlein purpura." Otherwise, it suggests "Criteria not met."

This evaluation is crucial for healthcare professionals to decide on further investigations and make management decisions for patients suspected of having HSP.

The EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura (HSP) is a diagnostic tool developed by the European League Against Rheumatism (EULAR), the Paediatric Rheumatology International Trials Organisation (PRINTO), and the Paediatric Rheumatology European Society (PRES). This calculator is specifically designed for the pediatric population, as HSP is primarily a disease of childhood.

The EULAR/PRINTO/PRES criteria for HSP is used to establish a diagnosis of HSP, a type of vasculitis that affects small blood vessels, typically presenting with palpable purpura, arthritis or arthralgia, abdominal pain, and renal involvement. The criteria include mandatory and additional criteria, and a diagnosis of HSP is made when the mandatory criterion (palpable purpura or petechiae, not related to thrombocytopenia) is present along with at least one of the additional criteria.

The clinical utility of this calculator is to aid in the diagnosis of HSP, which can help guide appropriate treatment and management strategies. It can also help differentiate HSP from other conditions that may present with similar symptoms.

There are no specific exclusion criteria for the use of the EULAR/

EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura

The tool evaluates the severity of IgA vasculitis nephritis by analyzing three critical clinical indicators: glomerular filtration rate (GFR), proteinuria levels, and the proportion of crescents detected in a renal biopsy. Each parameter has distinct options to choose from, aiding in determining the severity level of nephritis.

For glomerular filtration rate:
- Select between "Normal" which is greater than 80 mL/min/1.73 m², or "Impaired" which is lower.

Proteinuria is assessed by the urine protein/creatinine ratio:
- "Mild or Moderate" covers ratios below 100 mg/mmol or between 100-250 mg/mmol.
- "Severe persistent" encompasses a ratio above 250 mg/mmol for 4 weeks, over 100 mg/mmol for 3 weeks, or more than 50 mg/mmol for 6 weeks.

The crescent component requires examining biopsy results to note if crescents appear in:
- Less than 50% of glomeruli.
- More than 50% of glomeruli.

The severity is interpreted as follows based on your selections:

- Mild IgA vasculitis nephritis is identified when the GFR is normal and proteinuria is either mild or moderate.
- Moderate IgAV nephritis is considered if either the GFR is impaired or proteinuria is severe, with less than 50% crescents present.
- The case is regarded as severe IgAV nephritis when either the GFR is impaired or proteinuria is severe persistent, alongside more than 50% crescents.

This comprehensive evaluation ensures an accurate assessment of nephritis severity, essential for guiding clinical decisions and management strategies effectively.

The calculator in question is the Severity Grading for IgA Vasculitis Nephritis. This clinical scoring system is used specifically for patients diagnosed with IgA vasculitis, also known as Henoch-Schönlein purpura, who have developed kidney involvement, termed nephritis. 

The clinical utility of this calculator is to stratify the severity of nephritis in these patients, which can guide treatment decisions and provide prognostic information. The severity grading is based on various clinical and laboratory parameters including proteinuria, hematuria, and renal function. 

There are no specific exclusion criteria for its use, but it should be noted that this calculator is only applicable to patients with IgA vasculitis and not to other forms of vasculitis or kidney diseases. It is also important to remember that the severity grading should be used in conjunction with other clinical information and not as a standalone diagnostic tool.

Henoch-Schönlein purpura

Guidelines

Key sources