Nagamori et al reported a score for predicting severe gastrointestinal disease in a patient with Henoch-Schonlein purpura. The authors are from multiple institutions in Japan.
Patient selection: Henoch-Schonlein purpura
Parameters:
(1) white blood cell count per microliter
(2) absolute neutrophil count per microliter
(3) D-dimer in µg/dL
(4) factor XIII in percent
(5) serum sodium in mmol/L
(6) serum albumin in g/dL
Parameter
Finding
Points
WBC count
<= 10,000 per µL
0
10,001 to 15,000 per µL
1
> 15,000 per µL
2
absolute neutrophil count
<= 10,000 per µL
0
> 10,000 per µL
1
D-dimer
<= 4 µg/dL
0
4.01 to 8 µg/dL
1
8.01 to 12 µg/dL
2
> 12 µg/dL
3
Factor XIII
>= 75%
0
45 to 74.9%
1
< 45%
2
serum sodium
>= 136 mmol/L
0
< 136 mmol/L
1
serum albumin
>= 3.8 g/dL
0
< 3.8 g/dL
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• A score >= 4 indicated increased risk for gross intestinal bleeding.
Performance:
• A score >= 4 had a sensitivity of 90% and specificity of 81%.
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