Acar Banu Ç, Tekin Zahide E, Güngörer Vildan, Çelikel Elif, Kurt Tuba, Tekgöz Nilüfer, Sezer Müge, Karagöl Cüneyt, Coşkun Serkan, Kaplan Melike M, Polat Merve C, Öner Nimet, Kuruç Aylin I, Erten Elif E, Şenel Emrah
Division of Pediatric Rheumatology, Department of Pediatrics, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey.
Department of Pediatrics, University of Health Sciences, Ankara Bilkent City Hospital, Ankara, Turkey.
J Paediatr Child Health. 2023 Mar;59(3):505-511. doi: 10.1111/jpc.16335. Epub 2023 Jan 24.
To identify the risk factors associated with intussusception in children with immunoglobulin A vasculitis (IgAV)-gastrointestinal (GI) tract involvement and to evaluate the outcomes of medical treatment and surgical intervention and the course of patients with intussusception.
This retrospective study was conducted in 157 patients under 18 years of age who were followed up with the diagnosis of IgAV-GI tract involvement between January 2015 and September 2022. The characteristics of the patients who developed intussusception were evaluated in detail.
One hundred and fifty-seven patients with GI tract involvement were included in the study. The mean age of patients with IgAV-GI tract involvement was 8.7 ± 3.7 years. The female-to-male ratio was 1:1.5. Intussusception was detected in 14 patients (8.9%). Two patients (14.3%) underwent surgery, and the remaining 12 patients (85.7%) had their medical therapy intensified. Patients with GI tract involvement were divided into two groups as with (n = 14) and without (n = 143) intussusception. There was a statistically significant difference between the groups in the time from the onset of the first symptom of IgAV to the onset of steroids (P = 0.001). There were no statistically significant differences between the groups in age at onset of IgAV, gender distribution, erythrocyte sedimentation rate and C-reactive protein levels.
The time from the onset of the first symptom of IgAV to the start of steroids is a risk factor for the development of intussusception in patients with IgAV-GI tract involvement. In these patients, medical treatment usually reduces intussusception without the need for surgical intervention.
确定与免疫球蛋白A血管炎（IgAV）累及胃肠道的儿童肠套叠相关的危险因素，并评估药物治疗和手术干预的结果以及肠套叠患者的病程。
本回顾性研究纳入了2015年1月至2022年9月期间随访诊断为IgAV累及胃肠道的157例18岁以下患者。详细评估发生肠套叠的患者的特征。
157例累及胃肠道的患者纳入研究。IgAV累及胃肠道患者的平均年龄为8.7±3.7岁。男女比例为1:1.5。14例患者（8.9%）发生肠套叠。2例患者（14.3%）接受了手术，其余12例患者（85.7%）加强了药物治疗。累及胃肠道的患者分为发生肠套叠组（n = 14）和未发生肠套叠组（n = 143）。两组在从IgAV首发症状出现到开始使用类固醇的时间上存在统计学显著差异（P = 0.001）。两组在IgAV发病年龄、性别分布、红细胞沉降率和C反应蛋白水平方面无统计学显著差异。
从IgAV首发症状出现到开始使用类固醇的时间是IgAV累及胃肠道患者发生肠套叠的危险因素。在这些患者中，药物治疗通常可减少肠套叠，无需手术干预。
