924 The role of the neutrophil in childhood IgA vasculitis: a systematic review

Abstract

<h3>Background</h3> IgA vasculitis (IgAV), formerly known as Henoch-Schonlein purpura, is the most common form of vasculitis in children. Although IgAV is usually a self-limiting disease it can cause acute severe gastrointestinal (GI) inflammation and chronic kidney disease. The aetiology of IgAV is relatively unknown and although the neutrophil has been found to have a key role in other types of vasculitis it is not known if the neutrophil plays a role in IgAV. <h3>Objectives</h3> The aim of this study was to perform a systematic literature review to establish the role of the neutrophil in childhood IgAV and to identify any trends with phenotype. <h3>Methods</h3> PubMed, Ovid:Medline, Scopus and Web of Science were systematically searched using predefined criteria to identify studies which measured serum neutrophil levels in children with IgAV. The primary outcome of this review was neutrophil levels measured in the blood either presented as absolute neutrophil values or as a neutrophil:lymphocyte ratio (NLR). The study aimed to compare two key areas of interest. Firstly, the neutrophil levels compared between all patients with IgAV and age- and sex-matched healthy controls and secondly the neutrophil results between patients with IgAV with and without major organ involvement (defined as any GI or kidney involvement). <h3>Results</h3> The search identified 346 studies, of which a total of 11 studies, 2464 children, were included. The results showed a statistically significant increase in the absolute neutrophil levels in patients with IgAV compared to healthy controls and a strong association with gastrointestinal (GI) involvement. Neutrophil levels in children with IgAV-Nephritis (IgAV-N) did not show any significant difference. <h3>Conclusions</h3> The results suggest that the neutrophil does play a role in the disease course of childhood IgAV particularly when associated with GI system involvement.