First Affiliated Hospital of Henan University of Chinese Medicine, Henan Children's Hospital of Integrated Traditional Chinese and Western Medicine, Zhengzhou, China.
Henan University of Chinese Medicine, Zhengzhou, China.
Ann Med. 2021 Dec;53(1):2315-2320. doi: 10.1080/07853890.2021.2009554.
IgA vasculitis (IgAV) is a common small vessel vasculitis in children. Gastrointestinal perforation (GP) rarely presents as a complication of IgAV and is not well characterized. This study is aimed to investigate the clinical features, diagnosis, and risk factors of GP in children with IgAV.
We retrospectively reviewed the clinical data of children with IgAV who attended our hospital between January 2014 and June 2018. The clinical risk factors and the corresponding treatments were analyzed for the children with IgAV complication with GP.
In total, 10,791 children with IgAV were reviewed in this study. GP was observed in 11 children with IgAV, accounted for 0.10% of the total cases. Among those GP patients, 1 case was gastric perforation, 10 cases were intestinal perforation. Five GP cases were identified by abdominal CT. Ultrasonography was failed to detect the occurrence of GP in five cases. The average duration of abdominal pain in the GP cases was 9.3 days, and 9 cases (81.8%) presented with abdominal pain for over 7 days. Gastric/intestinal perforation repair were performed for 3 IgAV GP cases under open surgery. The other eight cases were treated through enterectomy. In comparison with the patients without GP, the GP patients had significant higher rates in the aspect of the abdominal or mixed type of IgAV, abdominal pain duration more than 7 days, hematochezia, renal damage, and methylprednisolone treatment with the daily dosage more than 2 mg/kg.
GP children accounted for 0.10% of the total IgAV cases. The risk of GP is elevated in IgAV patients who has gastrointestinal symptoms and/or other symptoms such as hematochezia, renal damage, a prolonged abdominal pain (>7 days), administration of methylprednisolone (>2 mg/kg). Abdominal CT is highly recommended for the early detection of GP in IgAV patients.Key messagesGastrointestinal perforation (GP) rarely presents as a complication of IgAV and is not well characterized.11 out of 10,791 children with IgAV developed GP, accounting for 0.10% of the total number of cases.Abdominal CT is highly recommended for the early detection of GP in IgAV patients.
IgA 血管炎（IgAV）是儿童常见的小血管血管炎。胃肠道穿孔（GP）很少作为 IgAV 的并发症出现，且其特征尚未完全明确。本研究旨在探讨儿童 IgAV 并发 GP 的临床特征、诊断和危险因素。
我们回顾性分析了 2014 年 1 月至 2018 年 6 月期间在我院就诊的 IgAV 患儿的临床资料。分析了伴有 GP 的 IgAV 患儿的临床危险因素和相应治疗方法。
本研究共回顾了 10791 例 IgAV 患儿。11 例 IgAV 患儿并发 GP，占总病例的 0.10%。在 GP 患儿中，1 例为胃穿孔，10 例为肠穿孔。5 例 GP 患儿通过腹部 CT 确诊。5 例患儿的超声检查未能检测到 GP 的发生。GP 患儿腹痛的平均持续时间为 9.3 天，9 例（81.8%）腹痛持续时间超过 7 天。3 例 IgAV GP 患儿采用剖腹手术进行胃/肠穿孔修复。另外 8 例患儿采用肠切除术治疗。与无 GP 的患儿相比，GP 患儿的腹部或混合性 IgAV、腹痛持续时间超过 7 天、血便、肾损伤以及甲基强的松龙治疗剂量（>2mg/kg）的发生率显著更高。
GP 患儿占 IgAV 患儿总数的 0.10%。胃肠道症状和/或其他症状（如血便、肾损伤、腹痛持续时间延长（>7 天）、接受甲基强的松龙（>2mg/kg）治疗）的 IgAV 患儿发生 GP 的风险较高。强烈建议对 IgAV 患儿行腹部 CT 检查以早期发现 GP。
