Abstract
Immunoglobulin A vasculitis (IgAV) is the most common systemic vasculitis in developmental age. The disease is most often characterized by a self-limiting course and good prognosis, but sometimes serious complications, like gastrointestinal bleeding or glomerulonephritis, may develop. The neutrophil to lymphocyte (NLR) and the platelet to lymphocyte (PLR) ratios are indicators related to clinical outcome in various inflammatory diseases. The mean platelet volume to platelet count ratio (MPR) has not been evaluated in patients with IgAV. The aim of this study was to analyze the values of the NLR, PLR and MPR in patients with an acute stage of IgAV compared to healthy children and to assess their suitability for predicting the severity of the disease. All children with IgAV hospitalized in our institution between 2012 and 2017 were reviewed retrospectively. The selected laboratory data were recorded before starting the treatment; these results allowed for NLR, PLR, and MPR calculation. The study involved 71 IgAV children. 57.7% of patients revealed signs of systemic involvement (including GT bleeding and/or glomerulonephritis) and 42.3% were nonsystemic (presenting skin and joint symptoms). 83% of patients were classified as mild and 17% as severe course of the disease. The NLR and the PLR were significantly higher in all IgAV children and in the systemic involvement group in comparison with non-systemic. The MPR was significantly lower in all IgAV group with the exception of children without systemic involvement. The NLR is a more valuable indicator than the PLR to identify patients at higher risk of systemic involvement in the course of IgAV. Clinical usefulness of the MPR requires further research.
Highlights
Immunoglobulin A vasculitis (IgAV), formerly known as Henoch-Schonlein Purpura, is the most common vasculitis in childhood
In searching for parameters useful for predicting the course of IgAV and making decisions about treatment, it is important to know the complex mechanisms responsible for migration and infiltration of neutrophils into the perivascular space, which contributes to the development of inflammation with their dominant participation [19]
The significantly higher neutrophil counts and the value of the NLR in children with IgAV documented in our study confirm their participation in the pathogenesis of the disease
Summary
Immunoglobulin A vasculitis (IgAV), formerly known as Henoch-Schonlein Purpura, is the most common vasculitis in childhood. It is a leukocytoclastic vasculitis with IgA1dominant immune deposits, affecting the small vessels of the skin, gastrointestinal tract, kidney and frequently causes arthritis [1]. The disease is most often characterized by a mild, self-limiting course and good prognosis, but in some cases, serious complications may develop. Symptoms from the gastrointestinal tract (GT) concern 50–70% of patients [2]; most often, these are abdominal pains and latent bleeding from GT. Haematemesis, melaena and severe complications such as intussusception or GT perforation are less frequent. Renal involvement occurs in 40–50% of cases,
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