ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 832

Immunoglobuline a Vasculitis: Comparison between Pediatric and Adult Population

Martin Brom1, Ignacio Javier Gandino2, Marina Scolnik3, Valeria Scaglioni3, Maria Britos4, Carmen De Cunto4 and Enrique R Soriano3, 1Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano de Buenos Aires, and Fundacion PM Catoggio, Buenos Aires, Argentina, 2Rheumatology Unit, Internal Medicine Service, Hospital Italiano de Buenos Aires, Instituto Universitario Hospital Italiano de Buenos Aires, and Fundacion PM Catoggio, Argentina., Buenos Aires, Argentina, 3Rheumatology Unit, Internal Medicine Service. Hospital Italiano Buenos Aires. Argentina, Buenos Aires, Argentina, 4Pediatric Rheumatology, Hospital Italiano De Buenos Aires, Buenos Aires, Argentina

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: Henoch-Schönlein purpura, Immunoglobulin (IG), Kidney, pediatric rheumatology and vasculitis

  • Tweet
  • Email
  • Print
Session Information

Date: Sunday, October 21, 2018

Session Title: Vasculitis Poster I: Non-ANCA-Associated and Related Disorders

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

Immunoglobuline A (IgA) Vasculitis, formerly known as Henoch-Schönlein purpura, is a small-vessel leukocytoclastic vasculitis due to deposition of IgA1, a subclass of IgA. Although it is mainly a pediatric disease, it can affect adults with an incidence rate of 1-8 cases/1000000 patients/year and it is reported to have a more aggressive course and worse renal outcome. There are scarce studies analyzing this association, and none in our region.

The purpose of the study is to describe the different features of the disease (clinical, laboratory, treatment and prognosis) both in pediatric and adult patients, and evaluate the differences between these groups, especially regarding renal outcome.

Methods:

We performed a retrospective review of the electronic medical records of all the patients with IgA vasculitis that were followed in a university hospital between 01/01/2000 and 05/01/2018. We included all patients that fulfilled the EULAR/PRINTO/PRES 2010 criteria ( European League Against Rheumatism/Paediatric Rheumatology International Trials Organisation/Paediatric Rheumatology European Society), and collected and analyzed demographic, clinical, treatment and histopathologic information available on their medical records.

We considered pediatric patients those who were under 20 years when they were diagnosed.

Results:

One-hundred eighteen patients were included, being 107 pediatric and 11 adults.

Table 1 shows demographic information, clinical manifestations, predisposing factors, treatment used, relapses, kidney outcome and deaths in both groups.

In our cohort, the adult group had more renal involvement. Kidney biopsy was performed in 5/8 of the affected patients, with confirmatory histopathology for IgA vasculitis in all of them.

Since adults showed more severe clinical manifestations, significantly more corticosteroids and immunosuppressants were used in this group.

As a consequence of the vasculitis, 2 of the affected adults suffered from chronic kidney disease, one of them required kidney transplant. No pediatric patient presented chronic kidney disease.

Finally, 2 deaths were found, both in the adult group, but only one related to the disease.

Conclusion: In our cohort, adult patients with IgA vasculitis suffered a more aggressive disease, with more renal involvement and required more intense treatment.

Table 1.

Pediatric Patients (n=107) Adult Patients (n=11) P
Male, n (%, 95% CI) 61 (57.0, 47.3-66.2) 8 (72.7, 39.5-91.6) 0.31
Age at diagnosis, years, median (IQR) 6.2 (4.4-9.5) 39.7 (27.6-72.3) <0.001
Follow-up, years, median (IQR) 7.3 (1.5-11.4) 9.3 (0.3-15.6) 0.47
Initial Clinical Manifestations
– Purpura, n (%, 95% CI) 107 (100) 11 (100) 1
– Abdominal pain, n (%, 95% CI) 62 (57.9, 48.3-67.0) 5 (45.4, 19.1-74.6) 0.43
– Proctorrhagia, n (%, 95% CI) 12 (11.2, 6.4-18.8) 1 (9.1, 1.1-46.9) 0.83
– Intussusception, n (%, 95% CI) 0 (0) 0 (0) 1
– Scalp edema, n (%, 95% CI) 45 (42.1, 32.9-51.7) 1 (9.1, 1.1-46.9) 0.03
– Arthritis, n (%, 95% CI) 30 (28.0, 20.2-37.4) 2 (18.2, 4.2-52.9) 0.48
– Arthralgia, n (%, 95% CI) 57 (53.3, 43.7-62.6) 2 (18.2, 4.2-52.9) 0.03
– Renal involvement, n (%,95% CI) 39 (36.4, 27.8-46.1) 8 (72.7, 39.5-91.6) 0.02
Predisposing Factors
Upper respiratory tract viral infection, n (%, 95% CI) 24 (44.4, 31.5-58.2) 2 (33.3, 6.9-76.9) 0.60
Streptococcal infection, n (%, 95% CI) 26 (48.2, 34.9-61.7) 0 0.02
None recognizable, n (%, 95% CI) 4 (7.4, 2.7-18.6) 4 (66.7, 23.1-93.0) <0.001
Unknown, n (%, 95% CI) 53 (49.5, 40.0-59.1) 5 (45.4, 19.1-74.6) 0.79
Initial Treatment
– Watch and wait, n (%, 95% CI) 52 (48.6, 39.1-58.1) 1 (9.1, 1.1-46.9) 0.01
– NSAIDs, n (%, 95% CI) 35 (32.7, 24.4-42.3) 2 (18.2, 4.2-52.9) 0.32
– Corticosteroids, n (%, 95% CI) 36 (33.6, 25.2-43.2) 9 (81.8, 47.0-95.8) 0.002
– Immunosuppressants, n (%, 95% CI) 1 (0.9, 0.1-6.5) 2 (18.2, 4.2-52.9) 0.001
Relapses, n (%, 95% CI) 18 (16.8, 10.8-25.3) 1 (9.1, 1.1-46.9) 0.51
Chronic kidney disease at the end of follow-up, n (%, 95% CI) 0 2 (18.2, 4.2-52.9) < 0.001
Death, n (%, 95% CI) 0 2 (18.2, 4.2-52.9) < 0.001

Disclosure: M. Brom, None; I. J. Gandino, None; M. Scolnik, None; V. Scaglioni, None; M. Britos, None; C. De Cunto, None; E. R. Soriano, AbbVie, Bristol-Myers Squibb, GSK, Janssen, Novartis, Pfizer Inc, Roche, UCB, 2,AbbVie, Bristol-Myers Squibb, Eli Lilly, GSK, Janssen, Novartis, Pfizer Inc, Roche, Sanofi, UCB, 5,AbbVie, Bristol-Myers Squibb, Eli Lilly, Janssen, Novartis, Pfizer Inc, Roche, Sandoz, UCB, 8.

To cite this abstract in AMA style:

Brom M, Gandino IJ, Scolnik M, Scaglioni V, Britos M, De Cunto C, Soriano ER. Immunoglobuline a Vasculitis: Comparison between Pediatric and Adult Population [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/immunoglobuline-a-vasculitis-comparison-between-pediatric-and-adult-population/. Accessed January 30, 2023.
  • Tweet
  • Email
  • Print

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/immunoglobuline-a-vasculitis-comparison-between-pediatric-and-adult-population/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences