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. 2021 Sep 1:40:e2020202.
doi: 10.1590/1984-0462/2022/40/2020202. eCollection 2021.

Intermittent abdominal pain in IgA vasculitis

[Article in English, Portuguese]
Izabel Mantovani Buscatti  1 , Juliana Russo Simon  1 , Vivianne Saraiva Leitao Viana  1 , Tamima Mohamad Abou Arabi  1 , Vitor Cavalcanti Trindade  1 , Ana Carolina Cortez Maia  1 , Lara Regina Cavalcante Melo  1 , Bianca Pires Ihara  1 , Nadia Emi Aikawa  1 , Clovis Artur Silva  1
Affiliations

Intermittent abdominal pain in IgA vasculitis

[Article in English, Portuguese]
Izabel Mantovani Buscatti et al. Rev Paul Pediatr. .

Abstract
in English, Portuguese

Objective: To assess intermittent abdominal pain in IgA vasculitis patients and its relation to demographic data, clinical manifestations and treatments.

Methods: A retrospective cohort study included 322 patients with IgA vasculitis (EULAR/PRINTO/PRES criteria) seen at the Pediatric Rheumatology Unit in the last 32 years. Sixteen patients were excluded due to incomplete data in medical charts. Intermittent abdominal pain was characterized by new abdominal pain after complete resolution in the first month of disease.

Results: Intermittent abdominal pain was observed in 35/306 (11%) IgA vasculitis patients. The median time between first and second abdominal pain was 10 days (3-30 days). The main treatment of intermittent abdominal pain included glucocorticoid [n=26/35 (74%)] and/or ranitidine [n=22/35 (63%)]. Additional analysis showed that the frequency of intermittent purpura/petechiae (37 vs. 21%; p=0.027) and the median of purpura/petechiae duration [20 (3-90) vs. 14 (1-270) days; p=0.014] were significantly higher in IgA vasculitis patients with intermittent abdominal pain compared to those without. Gastrointestinal bleeding (49 vs. 13%; p<0.001), nephritis (71 vs. 45%; p=0.006), glucocorticoid (74 vs. 44%; p=0.001) and intravenous immunoglobulin use (6 vs. 0%; p=0.036) were also significantly higher in the former group. The frequency of ranitidine use was significantly higher in IgA vasculitis patients with intermittent abdominal pain versus without (63 vs. 28%; p<0.001), whereas the median of ranitidine duration was reduced in the former group [35 (2-90) vs. 60 (5-425) days; p=0.004].

Conclusions: Intermittent abdominal pain occurred in nearly a tenth of IgA vasculitis patients, in the first 30 days of disease, and was associated with other severe clinical features. Therefore, this study suggests that these patients should be followed strictly with clinical and laboratorial assessment, particularly during the first month of disease course.

Objetivo:: Avaliar a dor abdominal intermitente em pacientes com vasculite por IgA e sua relação com dados demográficos, manifestações clínicas e tratamentos.

Métodos:: Um estudo de coorte retrospectiva incluiu 322 pacientes com vasculite por IgA (critérios EULAR/PRINTO/PRES) em uma Unidade de Reumatologia Pediátrica durante 32 anos. Dezesseis pacientes foram excluídos em razão de dados incompletos. A dor abdominal intermitente foi caracterizada por nova dor abdominal difusa após resolução completa no primeiro mês da doença.

Resultados:: Dor abdominal intermitente foi observada em 35/306 (11%) dos pacientes com vasculite por IgA. A mediana entre a primeira e a segunda dor abdominal foi 10 dias (3–30 dias). O principal tratamento incluiu glicocorticoide [n=26/35 (74%)] e/ou ranitidina [n=22/35 (63%)]. Análises adicionais mostraram que a frequência da púrpura/petéquia intermitente (37 vs. 21%; p=0,027) e a mediana da duração da púrpura/petéquia [20 (3–90) vs. 14 (1–270) dias; p=0,014] foram significativamente maiores em pacientes com vasculite por IgA com dor abdominal intermitente em comparação com aqueles sem essa condição. Sangramento gastrointestinal (49 vs. 13%; p<0,001), nefrite (71 vs. 45%; p=0,006), uso de glicocorticoides (74 vs. 44%; p=0,001) e de imunoglobulina endovenosa (6 vs. 0%; p=0,036) também foram maiores no primeiro grupo. A frequência do uso de ranitidina foi significativamente maior em pacientes com vasculite por IgA com dor abdominal intermitente versus sem dor (63 vs. 28%; p<0,001), ao passo que a mediana da duração do uso de ranitidina foi reduzida no primeiro grupo [35 (2–90) vs. 60 (5–425) dias; p=0,004].

Conclusões:: Dor abdominal intermitente ocorreu em, aproximadamente, um décimo dos pacientes com vasculite por IgA, nos primeiros 30 dias da doença, e foi associada a manifestações clínicas graves. Este estudo sugere, portanto, que esses pacientes devem ser seguidos rigorosamente com avaliação clínica e laboratorial, principalmente durante o primeiro mês da doença.

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Conflict of interest statement

Conflict of interests

The authors declare there is no conflict of interests.

References

    1. Buscatti IM, Casella BB, Aikawa NE, Watanabe A, Farhat SC, Campos LM, et al. Henoch-Schönlein purpura nephritis: initial risk factors and outcomes in a Latin American tertiary center. Clin Rheumatol. 2018;37:1319–1324. doi: 10.1007/s10067-017-3972-3. - DOI - PubMed
    1. Buscatti IM, Abrão HM, Kozu K, Marques VL, Gomes RC, Sallum AM, et al. Characterization of scrotal involvement in children and adolescents with IgA vasculitis. Adv Rheumatol. 2018;58:38–38. doi: 10.1186/s42358-018-0039-3. - DOI - PubMed
    1. Almeida JL, Campos LM, Paim LB, Leone C, Koch VH, Silva CA. Renal involvement in Henoch-Schönlein purpura: a multivariate analysis of initial prognostic factors. J Pediatr. 2007;83:259–266. doi: 10.2223/jped.1638. - DOI - PubMed
    1. Rabelo CR, Jr, Yamaguti R, Ribeiro AM, Melo BA, Campos LA, Silva CA. Hemorrhagic vesicle-bullous lesions in Henoch-Schönlein purpura and review of literature. Acta Reumatol Port. 2008;33:452–456. - PubMed
    1. Suehiro RM, Soares BS, Eisencraft AP, Campos LM, Silva CA. Acute hemorrhagic edema of childhood. Turk J Pediatr. 2007;49:189–192. - PubMed

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