Possible Threats of IgA Vasculitis in Children: One Center Experience

Introduction: Immunoglobulin A vasculitis (IgAV) is the most common vasculitis in children. Although typically self-limiting, IgAV may result in serious complications. Our objective was to evaluate the incidence, clinical features, laboratory predictors and outcomes of IgA vasculitis with gastroint...

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Main Authors: Eglė Lanzbergaitė-Manuilova, Skirmantė Rusonienė, Augustina Jankauskienė
Format: Article
Language:English
Published: Vilnius University Press 2024-12-01
Series:Acta Medica Lituanica
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Online Access:https://www.journals.vu.lt/AML/article/view/33347
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author Eglė Lanzbergaitė-Manuilova
Skirmantė Rusonienė
Augustina Jankauskienė
author_facet Eglė Lanzbergaitė-Manuilova
Skirmantė Rusonienė
Augustina Jankauskienė
author_sort Eglė Lanzbergaitė-Manuilova
collection DOAJ
description Introduction: Immunoglobulin A vasculitis (IgAV) is the most common vasculitis in children. Although typically self-limiting, IgAV may result in serious complications. Our objective was to evaluate the incidence, clinical features, laboratory predictors and outcomes of IgA vasculitis with gastrointestinal (GI) and kidney involvement. Methods: Medical records of patients <18 years of age with newly diagnosed IgAV between 2013 and 2021 in a single center were analyzed. Demographic, clinical, laboratory data, and incidence of GI and kidney involvement data were analyzed. As laboratory predictors, neutrophil, lymphocyte, platelets count, mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) were calculated. Results: 240 patients with IgAV were included. GI involvement was in 104 patients (43.3%), whereas kidney involvment in 21 patients (8.8%).  Age was the only variable associated with increased odds of kidney involvement (OR 3.5, 95% confidence interval 1.39–8.56, p=0.009). None of the laboratory predictors or other tested variables was associated with kidney involvement in univariable logistic regression. The neutrophil and lymphocyte count, NLR and PLR levels were found to be significantly higher in children with GI involvement. There were no bad outcomes: lethal outcome or chronic kidney disease for the patients with GI and kidney involvement in recent study. During two years of surveillance after IgAV diagnosis, 11 cases (4.6%) had indications for kidney biopsy and were diagnosed with IgAV nephritis. Conclusions:  Older children were more likely to have kidney disease. Easy obtained laboratory parameters such as NLP, PLR could help to predict GI involvement in early disease stage, but had no value for predicting kidney involvement.
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spelling doaj-art-d2b820d90e6248a4ad2c511438b973252025-02-09T18:08:26ZengVilnius University PressActa Medica Lituanica1392-01382029-41742024-12-0131210.15388/Amed.2024.31.2.4Possible Threats of IgA Vasculitis in Children: One Center ExperienceEglė Lanzbergaitė-Manuilova0https://orcid.org/0009-0002-9041-0697Skirmantė Rusonienė1https://orcid.org/0000-0001-6156-1045Augustina Jankauskienė2https://orcid.org/0000-0001-7767-2102Pediatric Center, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, LithuaniaPediatric Center, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, LithuaniaPediatric Center, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania Introduction: Immunoglobulin A vasculitis (IgAV) is the most common vasculitis in children. Although typically self-limiting, IgAV may result in serious complications. Our objective was to evaluate the incidence, clinical features, laboratory predictors and outcomes of IgA vasculitis with gastrointestinal (GI) and kidney involvement. Methods: Medical records of patients <18 years of age with newly diagnosed IgAV between 2013 and 2021 in a single center were analyzed. Demographic, clinical, laboratory data, and incidence of GI and kidney involvement data were analyzed. As laboratory predictors, neutrophil, lymphocyte, platelets count, mean platelet volume (MPV) and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) were calculated. Results: 240 patients with IgAV were included. GI involvement was in 104 patients (43.3%), whereas kidney involvment in 21 patients (8.8%).  Age was the only variable associated with increased odds of kidney involvement (OR 3.5, 95% confidence interval 1.39–8.56, p=0.009). None of the laboratory predictors or other tested variables was associated with kidney involvement in univariable logistic regression. The neutrophil and lymphocyte count, NLR and PLR levels were found to be significantly higher in children with GI involvement. There were no bad outcomes: lethal outcome or chronic kidney disease for the patients with GI and kidney involvement in recent study. During two years of surveillance after IgAV diagnosis, 11 cases (4.6%) had indications for kidney biopsy and were diagnosed with IgAV nephritis. Conclusions:  Older children were more likely to have kidney disease. Easy obtained laboratory parameters such as NLP, PLR could help to predict GI involvement in early disease stage, but had no value for predicting kidney involvement. https://www.journals.vu.lt/AML/article/view/33347IgA vasculitis gastrointestinal involvement kidney involvement laboratory predictors
spellingShingle Eglė Lanzbergaitė-Manuilova
Skirmantė Rusonienė
Augustina Jankauskienė
Possible Threats of IgA Vasculitis in Children: One Center Experience
Acta Medica Lituanica
IgA vasculitis
gastrointestinal involvement
kidney involvement
laboratory predictors
title Possible Threats of IgA Vasculitis in Children: One Center Experience
title_full Possible Threats of IgA Vasculitis in Children: One Center Experience
title_fullStr Possible Threats of IgA Vasculitis in Children: One Center Experience
title_full_unstemmed Possible Threats of IgA Vasculitis in Children: One Center Experience
title_short Possible Threats of IgA Vasculitis in Children: One Center Experience
title_sort possible threats of iga vasculitis in children one center experience
topic IgA vasculitis
gastrointestinal involvement
kidney involvement
laboratory predictors
url https://www.journals.vu.lt/AML/article/view/33347
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