Department of Pediatrics, Hospital Bicêtre, University Paris Sud, Le Kremlin Bicêtre, Paris, France.
Curr Opin Rheumatol. 2013 Mar;25(2):171-8. doi: 10.1097/BOR.0b013e32835d8e2a.
To review the current knowledge of epidemiological features of immunoglobulin (Ig) A vasculitis (Henoch-Schönlein) and disease etiology.
The annual incidence of IgA vasculitis in the population is an estimated 3-26.7/100 000 for children and infants and 0.8-1.8/100 000 for adults. These may be conservative approximations of the true frequency because of skewed case-finding strategies. In children, the marked autumn-winter peak in incidence rates, the frequent occurrence after an upper respiratory tract infection and the short interval between disease onset in index cases and in other family members collectively point to a transmissible infectious process. A subset of adult IgA vasculitis could be related to preceding or concurrent malignancies. Despite several lines of evidence supporting the critical role of an exogenous factor in IgA vasculitis, recent progress has been made in understanding the genetic susceptibility to IgA vasculitis. Recent findings also lessened the suggestion that IgA vasculitis might be triggered by vaccination.
IgA vasculitis is two to 33 times more common in children than adults and appears to have a strong environmental component, with possibly different risk factors in childhood and adulthood. Support is strengthening for a role of genetics in IgA vasculitis.
回顾 IgA 血管炎（过敏性紫癜）的流行病学特征和病因学的现有知识。
IgA 血管炎在人群中的年发病率估计为儿童和婴儿 3-26.7/100000，成人 0.8-1.8/100000。由于病例发现策略的偏倚，这些可能是真实频率的保守估计。在儿童中，发病率呈明显的秋冬高峰，常在上呼吸道感染后发生，且在首例患者和其他家庭成员之间疾病发病的间隔较短，这些都指向一种可传播的感染过程。一部分成人 IgA 血管炎可能与先前或同时发生的恶性肿瘤有关。尽管有几条证据支持外源性因素在 IgA 血管炎中的关键作用，但在理解 IgA 血管炎的遗传易感性方面已取得了一些进展。最近的发现也减少了 IgA 血管炎可能由疫苗接种引发的提示。
IgA 血管炎在儿童中的发病率是成人的 2 至 33 倍，似乎具有很强的环境成分，在儿童和成人中可能有不同的危险因素。越来越多的证据表明遗传学在 IgA 血管炎中起作用。
