Epidemiological and clinical aspects of immunoglobulin A vasculitis in childhood: a retrospective cohort study

Ital J Pediatr. 2021 Dec 15;47(1):237. doi: 10.1186/s13052-021-01182-6.

Abstract

Background: A retrospective study was conducted in order to investigate and describe the characteristics of Immunoglobulin A vasculitis (IgAV), previously known as Henoch-Schӧnlein purpura, in the paediatric population of a community-based healthcare delivery system in the Italian region of Abruzzo.

Methods: This is a population-based retrospective chart review of the diagnosis of IgAV in children ages 0 to 18, admitted to the Department of Paediatrics of Chieti and Pescara between 1 January 2000 and 31 December 2016. All children enrolled presented with clinical symptoms and laboratory findings and met the EULAR/PRINTO/PRES 2008 criteria.

Results: Two-hundred-eight children met the criteria for IgAV, with the highest incidence reported among children below 7-years of age. A correlation with recent infections was found in 64% of the cohort; the onset was more frequently during the winter and fall. Purpura had a diffuse distribution in the majority of patients; joint impairment was the second most frequent symptom (43%), whereas the gastrointestinal tract was involved in 28% of patients.

Conclusions: Hereby, we confirm the relative benignity of IgAV in a cohort of Italian children; with regards to renal involvement, we report a better outcome compared to other studies. However, despite the low rate of renal disease, we observed a wide use of corticosteroids, especially for the treatment of persistent purpura.

Keywords: Henoch-Schӧnlein purpura; Immunoglobulin A vasculitis; Pediatrics.

MeSH terms

  • Abdominal Pain / epidemiology
  • Adolescent
  • Age Distribution
  • Anemia / epidemiology
  • Arthralgia / epidemiology
  • Arthritis / epidemiology
  • Blood Sedimentation
  • C-Reactive Protein / analysis
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Glucocorticoids / therapeutic use
  • Hospitalization
  • Humans
  • IgA Vasculitis / epidemiology*
  • IgA Vasculitis / therapy
  • Immunosuppressive Agents / therapeutic use
  • Infant
  • Infant, Newborn
  • Infections / epidemiology
  • Italy / epidemiology
  • Kidney Diseases / epidemiology
  • Kidney Diseases / etiology
  • Leukocytosis / epidemiology
  • Male
  • Purpura / epidemiology
  • Retrospective Studies
  • Seasons
  • Sex Distribution
  • Thrombocytosis / epidemiology

Substances

  • Glucocorticoids
  • Immunosuppressive Agents
  • C-Reactive Protein