Professional paper

https://doi.org/10.33004/reumatizam-68-1-3

Clinical and laboratory features of IgA vasculitis with gastrointestinal involvement: a 12-year experience of the Referral Centre for Paediatric and Adolescent Rheumatology of the Republic of Croatia

Martina Held ; Division of Clinical Immunology, Allergology and Rheumatology, Referral Centre for Paediatric and Adolescent Rheumatology of the Ministry of Health of the Republic of Croatia, Department of Paediatrics, School of Medicine, University of Zagreb, University Hospital Centre Zagreb, Zagreb
Mario Šestan ; Division of Clinical Immunology, Allergology and Rheumatology, Referral Centre for Paediatric and Adolescent Rheumatology of the Ministry of Health of the Republic of Croatia, Department of Paediatrics, School of Medicine, University of Zagreb, University Hospital Centre Zagreb, Zagreb
Nastasia Kifer ; Division of Clinical Immunology, Allergology and Rheumatology, Referral Centre for Paediatric and Adolescent Rheumatology of the Ministry of Health of the Republic of Croatia, Department of Paediatrics, School of Medicine, University of Zagreb, University Hospital Centre Zagreb, Zagreb
Danica Grgurić ; Division of Clinical Immunology, Allergology and Rheumatology, Referral Centre for Paediatric and Adolescent Rheumatology of the Ministry of Health of the Republic of Croatia, Department of Paediatrics, School of Medicine, University of Zagreb, University Hospital Centre Zagreb, Zagreb
Sara Mudri ; Division of Clinical Immunology, Allergology and Rheumatology, Referral Centre for Paediatric and Adolescent Rheumatology of the Ministry of Health of the Republic of Croatia, Department of Paediatrics, School of Medicine, University of Zagreb, University Hospital Centre Zagreb, Zagreb
Marijan Frković ; Division of Clinical Immunology, Allergology and Rheumatology, Referral Centre for Paediatric and Adolescent Rheumatology of the Ministry of Health of the Republic of Croatia, Department of Paediatrics, School of Medicine, University of Zagreb, University Hospital Centre Zagreb, Zagreb
Marija Jelušić ; Division of Clinical Immunology, Allergology and Rheumatology, Referral Centre for Paediatric and Adolescent Rheumatology of the Ministry of Health of the Republic of Croatia, Department of Paediatrics, School of Medicine, University of Zagreb, University Hospital Centre Zagreb, Zagreb

Abstract

Introduction. IgA vasculitis (IgAV ) is the most common systemic vasculitis in childhood. More than half of IgAV patients experience gastrointestinal involvement which usually occurs in the form of abdominal pain, nausea and vomiting, and up to 5% of patients may develop serious complications such as intussusception, intestinal perforation and / or acute bleeding. The aim of our study was to determine the clinical and laboratory features of gastrointestinal involvement in IgAV . Materials and methods. Retrospective analysis of IgAV patients’ data, who were diagnosed and treated at the R
eferral Centre for Paediatric and Adolescent Rheumatology of the Ministry of Health of the Republic of Croatia, in the period from 2009 to 2020, and who experienced gastrointestinal involvement. Differences between categorical variables were examined using the χ2 test, and between the numerical ones using the Mann-Whitney U-test. Results. IgAV was diagnosed in 216 patients, 116 boys and 100 girls. Gastrointestinal involvement was detected in 94 patients (43.5%), the age range at diagnosis was 6.75 (5.2 – 9), and the M : F ratio was 1.68 : 1. The most common clinical sign of gastrointestinal involvement in IgA vasculitis was abdominal pain which occurred in 45 patients (47.9%). Abdominal pain was most often located in the periumbilical region (62.5%). One patient developed ileocolic intussusception. The incidence of generalised purpuric rash (p = 0,023) and nephritis (p = 0,001) was higher in patients with gastrointestinal involvement compared to a group of patients without gastrointestinal involvement. This group of patients had statistically significantly higher values of leukocyte count (p = 0,021) and lower values of erythrocyte sedimentation rate (p = 0,039) and total serum proteins (p = 0,002). In the majority of cases, patients with gastrointestinal involvement were male (p = 0,019), their length of stay (LoS) in the hospital was longer (p < 0,001) and they had a higher frequency of relapses (p = 0,011). Conclusion. In conclusion, gastrointestinal symptoms in IgAV are most often self-limiting, while complications are rare. We observed that, in most cases, patients with gastrointestinal symptoms
were males, with longer length of stay in the hospital, and a higher frequency of nephritis and relapses.

Keywords

Henoch-Schönlein purpura; Vasculitis; Gastrointestinal tract; Children; Adolescents

Hrčak ID:

280232

URI

https://hrcak.srce.hr/280232

Publication date:

11.7.2022.

Article data in other languages: croatian

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