The Factors Affecting the Occurrence of Renal Involvement in Children with IgA Vasculitis

Abstract

Introduction: Henoch-Schönlein purpura or IgA vasculitis that involves small vessels is the most common vasculitis in childhood and the long term prognosis is contingent on the severity of renal involvement. Objectives: In this study, we aimed to determine the frequency of organ involvements and to identify potential risk factors for renal involvement in children with IgA vasculitis. Materials and Methods: This study included 416 patients with IgA vasculitis who had been followed in our department between 1990 and 2016. The patients were retrospectively reviewed in terms of type of treatment, organ involvement and clinical outcome, and potential risk factors for renal involvement were determined. Results: Overall, 416 patients with IgA vasculitis were identified, including 174 girls (41.7%) and 242 boys (58.3%). The mean age at presentation was 8.3±3.1 years. The distribution of organ involvement was: skin involvement, 100%; joint involvement, 77.1%; gastrointestinal system (GIS) involvement, 58.6%; renal involvement, 38.3%; scalp edema, 10.1%; scrotal involvement, 5.3% (9.0% in boys), central nervous system (CNS) involvement, 1.6% and pulmonary involvement, 0.25%. When risk factors for renal involvement were assessed, it was found that GIS involvement was more frequently seen in patients with nephritis (p=0.01). Age, diastolic blood pressure and GIS involvement at the onset were found to be correlated with renal involvement. GIS involvement and diastolic blood pressure were found as risk factors for renal involvement. Conclusion: Age, elevation in diastolic blood pressure and GIS involvement were important findings in prediction of nephritis. In particular, patients with GIS involvement should be cautiously monitored for renal involvement.