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欧洲基于共识的儿童罕见血管炎诊断和治疗推荐 - SHARE 倡议。

European consensus-based recommendations for the diagnosis and treatment of rare paediatric vasculitides - the SHARE initiative.

机构信息

Department of Paediatric Rheumatology, Wilhelmina Children's Hospital, Utrecht.

Department of Paediatric Rheumatology, Sophia Children's Hospital, Erasmus Medical Centre, Rotterdam, The Netherlands.

出版信息

Rheumatology (Oxford). 2019 Apr 1;58(4):656-671. doi: 10.1093/rheumatology/key322.

DOI:10.1093/rheumatology/key322
PMID:30535249
Abstract

OBJECTIVES

The European initiative Single Hub and Access point for paediatric Rheumatology in Europe (SHARE) aimed to optimize care for children with rheumatic diseases. Systemic vasculitides are very rare in children. Consequently, despite recent advances, paediatric-specific information is sparse. The lack of evidence-based recommendations is an important, unmet need. This study aimed to provide recommendations for diagnosing and treating children with rare forms of childhood systemic vasculitis.

METHODS

Recommendations were developed by a consensus process in accordance with the European League Against Rheumatism standard operating procedures. A systematic literature review informed the recommendations, which were devised and evaluated by a panel of experts via an online survey, and two consensus meetings using nominal group technique. Recommendations were accepted when ⩾ 80% of experts agreed.

RESULTS

Ninety-three relevant articles were found, and 78 recommendations were accepted in the two consensus meetings. General, cross-cutting recommendations and disease-specific statements regarding the diagnosis and treatment of childhood-onset PAN, granulomatosis with polyangiitis, microscopic polyangiitis, eosinophilic granulomatosis with polyangiitis, and Takayasu arteritis are provided.

CONCLUSION

These Single Hub and Access point for paediatric Rheumatology in Europe recommendations were formulated through an evidence-based consensus process to support uniform, high-quality standard of care for children with rare forms of paediatric systemic vasculitis.

摘要

目的

欧洲小儿风湿病学单一联络点和接入点倡议(SHARE)旨在优化儿童风湿病患者的护理。儿童系统性血管炎非常罕见。因此,尽管最近取得了进展,但儿童特异性信息仍然很少。缺乏基于证据的建议是一个重要的未满足需求。本研究旨在为诊断和治疗儿童罕见类型的儿童系统性血管炎提供建议。

方法

建议是按照欧洲抗风湿病联盟标准操作规程通过共识过程制定的。系统文献复习为建议提供了信息,这些建议由专家组通过在线调查以及使用名义小组技术的两次共识会议进行设计和评估。当 ⩾ 80%的专家达成一致时,建议被接受。

结果

共发现 93 篇相关文章,在两次共识会议上接受了 78 条建议。提供了关于儿童发病的巨细胞动脉炎、肉芽肿性多血管炎、显微镜下多血管炎、嗜酸性肉芽肿伴多血管炎和 Takayasu 动脉炎的一般、跨领域建议和疾病特异性陈述,用于诊断和治疗。

结论

这些欧洲小儿风湿病学单一联络点和接入点建议是通过循证共识过程制定的,旨在为儿童罕见类型的儿童系统性血管炎提供统一、高质量的护理标准。

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