Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430015, China.
Curr Med Sci. 2021 Oct;41(5):888-893. doi: 10.1007/s11596-021-2440-0. Epub 2021 Sep 20.
Although relatively rare, adult immunoglobulin A vasculitis (IgAV) can lead to severe complications and longer hospitalization, and result in poor prognosis, when compared to childhood IgAV. Hence, early identification and prevention for patients prone to develop systemic involvement are essential. The purpose of this study was to explore the correlations of common serological markers with the development of systemic involvement in adult IgAV.
A retrospective analysis was performed for adult IgAV patients, who were hospitalized in Wuhan Union Hospital between January 2016 and December 2019. A total of 259 patients were enrolled, and the pre-treatment serological markers were comprehensively assessed.
In the present study, 49.0% and 33.2% of patients developed renal and gastrointestinal (GI) involvement, respectively. Furthermore, the elevated levels of white blood cells count, D-Dimer (D-D), C-reactive protein (CRP) and neutrophil granulocyte ratio (NE%) >60% were significantly associated with GI involvement in the univariate analysis, while the decrease in high density lipoprotein level, and the elevated D-D and CRP levels were significantly associated with renal involvement (P<0.05). Moreover, a prediction model that combined multiple markers was established by performing a logistic regression analysis, and this presented a more favorable value of prediction than the individual serological markers.
The present study suggests that common serological markers have close correlations with systemic involvement in adult IgAV, and that the establishment of a prediction model for systemic involvement may be helpful in facilitating personalized therapeutic strategies and clinical management for IgAV patients.
与儿童 IgAV 相比，成人免疫球蛋白 A 血管炎（IgAV）相对少见，但可导致严重并发症和更长的住院时间，预后较差。因此，早期识别和预防易发生系统性受累的患者至关重要。本研究旨在探讨常见血清学标志物与成人 IgAV 发生系统性受累的相关性。
对 2016 年 1 月至 2019 年 12 月期间在武汉协和医院住院的成人 IgAV 患者进行回顾性分析。共纳入 259 例患者，全面评估治疗前的血清学标志物。
本研究中，49.0%和 33.2%的患者分别发生肾脏和胃肠道（GI）受累。此外，白细胞计数、D-二聚体（D-D）、C 反应蛋白（CRP）和中性粒细胞比例（NE%）>60%升高与 GI 受累在单因素分析中显著相关，而高密度脂蛋白水平降低以及 D-D 和 CRP 水平升高与肾脏受累显著相关（P<0.05）。此外，通过进行逻辑回归分析建立了一个结合多个标志物的预测模型，与单个血清学标志物相比，该模型具有更优的预测价值。
本研究表明，常见的血清学标志物与成人 IgAV 的系统性受累密切相关，建立系统性受累的预测模型可能有助于为 IgAV 患者制定个性化的治疗策略和临床管理。
