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. 2023 Aug 8:11:1194214.
doi: 10.3389/fped.2023.1194214. eCollection 2023.

Severe gastrointestinal involvement in pediatric IgA vasculitis: a retrospective single-center cohort study in China

Yifan Li  1 , Xiaomei Zhang  1 , Haimei Liu  1 , Guomin Li  1 , Wanzhen Guan  1 , Tao Zhang  1 , Qiaoqian Zeng  1 , Yinv Gong  1 , Hong Xu  1   2 , Li Sun  1
Affiliations

Severe gastrointestinal involvement in pediatric IgA vasculitis: a retrospective single-center cohort study in China

Yifan Li et al. Front Pediatr. .

Abstract

Objectives: The study aimed to describe the characteristics of gastrointestinal (GI) involvement in a cohort of hospitalized children with IgA vasculitis (IgAV) in China.

Method: We reviewed the records of hospitalized IgAV patients from January 2014 to December 2020 at one tertiary medical center. The patients were divided into the severe GI group and the non-severe GI group according to the presence of massive GI bleeding and complications. The clinical manifestations, laboratory factors, and treatment were analyzed between the two groups.

Results: A total of 1,179 patients were hospitalized due to IgAV. GI involvement was noted in 50% (589) of the patients, of whom 288 (48.9%) had severe GI involvement. GI complications were observed in 34 patients with IgAV with GI involvement. Rare onset age (<3 years or within 13-17 years), purpura above the waist, vomiting, high neutrophil-to-lymphocyte ratio, and decreased serum albumin were factors associated with severe GI involvement. Frequencies of renal involvement and biopsy-proven nephritis were higher in the severe GI group. The most commonly used medications were corticosteroids (100.0%) in the severe GI group. The maximum corticosteroid dose was higher (2.9 vs. 2.0 mg/kg), and more second-line therapies were needed (30.9% vs. 16.94%) in the severe GI group.

Conclusions: Severe GI involvement in children is common in our center. Rare onset age, purpura above the waist, vomiting, high neutrophil-to-lymphocyte ratio, and decreased serum albumin are associated with severe GI involvement. Patients with severe GI involvement need higher doses of corticosteroids and second-line therapy.

Keywords: IgA vasculitis; gastrointestinal involvement; pediatric; severe; treatment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Multivariate logistic regression analysis of the association of rare onset age, purpura above the waist, vomiting, NLR, and serum albumin with severe GI involvement in IgAV patients.
See this image and copyright information in PMC

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