Clinico-Epidemiological Profile and Outcome of Children with IgA Vasculitis in Aseer Region, Southwestern Saudi Arabia.

Samy A Dawood,Mohammed A Alshehri,Abdoh M Abodiah,Syed E Mahmood,Ayed A Shati,Saleh M Alqahtani,Youssef A Alqahtani

doi:10.3390/healthcare9121694

Samy A Dawood, Mohammed A Alshehri + Show 5 more

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https://doi.org/10.3390/healthcare9121694

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Abstract

Introduction: Immunoglobulin A (IgA) vasculitis is one of the most common forms of primary vasculitis in children; it typically has a benign course but can be aggressive and require intervention. Aim of the work: The aim of this retrospective study was to evaluate the epidemiological and clinical profile and treatment modalities used for children with IgA vasculitis in the southwestern region of Saudi Arabia. Material and Methods: We reviewed the medical records of 89 children admitted to Abha Maternity and Children Hospital in the southwestern region of Saudi Arabia from January 2016 to December 2020 with a confirmed diagnosis of IgA vasculitis according to the European League Against Rheumatism/Paediatric Rheumatology International Trials Organisation/Pediatric Rheumatology European Society criteria. Results: Eighty-nine children had a confirmed diagnosis of IgA vasculitis, with 50 boys (56.2%) and 39 girls (43.8%; male-to-female ratio of 1.28:1) and a mean age at diagnosis of 5.87 ± 2.81 years. The mean hospital stay duration was 5.66 ± 4.72 days. Infections preceded 29.2% of the cases, with upper respiratory tract infections comprising 24.7%. Approximately 31.5% of the cases were diagnosed in summer, followed by autumn in 28% of the cases. Rash was present in 100%, arthritis in 72.2%, gastrointestinal tract involvement in 60.7%, and renal involvement in 23.5% of cases. Thrombocytosis and leukocytosis were found in 35% and 46% of all cases, and 52.3% and 47.6.25% of cases with renal involvement, respectively (OR = 2.035, 95% CI: 0.75–5.52 and OR = 1.393, 95% CI: 0.522–1.716, respectively). Approximately 26% of cases experienced relapses. Treatment was conservative in 23.6%, oral prednisolone in 23.6%, and pulse steroid in 45% of cases. Abdominal pain with lower gastrointestinal tract bleeding was the primary indication for initiating pulse steroid treatment. Conclusions: There were similarities and differences in the epidemiology and frequency of clinical manifestations of patients with IgA vasculitis compared to previous studies. Children presenting with such epidemiological and clinical profile need to be closely monitored and long-term follow-up is recommended to improve the outcomes.

Highlights

Immunoglobulin A (IgA) vasculitis is one of the most common forms of primary vasculitis in children; it typically has a benign course but can be aggressive and require intervention
Immunoglobulin A (IgA) vasculitis involves the deposition of immune complexes containing IgA into small vessels, commonly affecting the gastrointestinal tract (GIT), joints, and kidneys, and less commonly the testicles and central nervous system
IgA plays a crucial role in the immune pathogenesis of IgA vasculitis, as indicated by the increased serum IgA concentration and IgA deposition in the vessel walls and renal glomeruli seen in patients with IgA vasculitis [4]

Summary

Introduction

Immunoglobulin A (IgA) vasculitis is one of the most common forms of primary vasculitis in children; it typically has a benign course but can be aggressive and require intervention. Conclusions: There were similarities and differences in the epidemiology and frequency of clinical manifestations of patients with IgA vasculitis compared to previous studies Children presenting with such epidemiological and clinical profile need to be closely monitored and long-term follow-up is recommended to improve the outcomes. IgA vasculitis is predominantly a disease of childhood, occurring most frequently between 3 and 15 years of age, with 50% of all cases occurring in children under 5 years of age It is more common in males than females, with a male-to-female ratio of 1.5:1, and the peak disease incidence occurs in winter and spring, though there is variability and clusters of cases in other seasons [1,2]. IgA plays a crucial role in the immune pathogenesis of IgA vasculitis, as indicated by the increased serum IgA concentration and IgA deposition in the vessel walls and renal glomeruli seen in patients with IgA vasculitis [4]

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