IgA vasculitis in adults, pediatrics and non-vasculitic IgA nephropathy, retrospective analysis from 2 centers

Medicine (Baltimore). 2023 Dec 15;102(50):e36521. doi: 10.1097/MD.0000000000036521.

Abstract

Renal involvement represents the major long-term morbidity associated with IgA vasculitis (IgAV). Our aim was to evaluate clinical characteristics and long-term renal outcomes of IgAV in pediatrics and adults comparing to IgA nephropathy (IgAN). Our retrospective study included children and adults with IgAV and IgAN patients, admitted in a 13-year period (2007-2019) to rheumatology clinics and in hospital pediatric and internal medicine departments. We compared frequencies of clinical manifestations, laboratory findings, treatments, long-term outcomes at 1 year follow-up, including all-cause mortality and dialysis until the end of follow-up time. A total of 60 adult IgAV, 60 pediatric IgAV and 45 IgAN patients were evaluated. Adult IgAV patients were significantly older than IgAN patients (53.1 ± 17.4 years vs 45.1 ± 15.7 years respectively, P = .02) and had significantly higher rates of cardiovascular comorbidities. The risk and time to dialysis were similar among IgAN and adult IgAV groups. Yet, overall mortality at long term follow up was higher in IgAV adult group compared to IgAN. No dialysis or renal transplantation were reported in pediatric IgAV patients. IgAV and IgAN adult patients were comparable regarding risk of end stage renal disease. Of note, high mortality rates were observed among adult IgAV group.

MeSH terms

  • Adult
  • Aged
  • Child
  • Glomerulonephritis, IGA* / complications
  • Glomerulonephritis, IGA* / epidemiology
  • Glomerulonephritis, IGA* / therapy
  • Humans
  • IgA Vasculitis* / complications
  • IgA Vasculitis* / epidemiology
  • IgA Vasculitis* / therapy
  • Immunoglobulin A
  • Middle Aged
  • Renal Dialysis
  • Retrospective Studies

Substances

  • Immunoglobulin A