Intussusception as a rare manifestation of immunoglobulin A vasculitis: Risk factors and treatment

• Published in: Journal of paediatrics and child health Vol. 59; no. 3; pp. 505 - 511
• Main Authors: 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
• Format: Journal Article
• Language: English
• Published: Australia John Wiley & Sons Australia, Ltd 01-03-2023; Blackwell Publishing Ltd
• Subjects: Adolescent; Child; Child, Preschool; children; Female; gastrointestinal tract involvement; Health risks; Humans; IgA Vasculitis - complications; IgA Vasculitis - diagnosis; Immunoglobulin A; immunoglobulin A vasculitis; Immunoglobulins; Inflammatory diseases; Intestinal obstruction; intussusception; Intussusception - etiology; Intussusception - therapy; Male; Medical treatment; Pediatrics; Retrospective Studies; Risk Factors; Steroids; Vein & artery diseases; intussusception; immunoglobulin A vasculitis; children; gastrointestinal tract involvement
• ISSN: 1034-4810; 1440-1754
• DOI: 10.1111/jpc.16335

Aim
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.
Methods
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.
Results
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.
Conclusions
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.