Preadolescent‐versus adolescent‐onset immunoglobulin A vasculitis: The impact of age on prognosis

• Published in: Pediatrics international Vol. 65; no. 1; pp. e15426 - n/a
• Main Authors: Coşkun, Serkan, Güngörer, Vildan, Ekici Tekin, Zahide, Çelikel, Elif, Kurt, Tuba, Tekgöz, Nilüfer, Sezer, Müge, Karagöl, Cüneyt, Kaplan, Melike Mehveş, Polat, Merve Cansu, Öner, Nimet, Acar, Banu Çelikel
• Format: Journal Article
• Language: English
• Published: Australia Blackwell Publishing Ltd 01-01-2023
• Subjects: Adolescent; Adolescents; Age; Child; Demography; Gastrointestinal tract; Humans; IgA Vasculitis - diagnosis; Immunoglobulin A; immunoglobulin A vasculitis; Immunoglobulins; Kidney; Male; Patients; Pediatrics; Prognosis; Purpura; Retrospective Studies; Rheumatology; severity; Teenagers; Vasculitis; severity; adolescent; immunoglobulin A vasculitis; prognosis; child
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1111/ped.15426

Background
This study aimed to investigate the characteristics of patients with preadolescent‐ and adolescent‐onset immunoglobulin A vasculitis (IgAV) and to determine whether age affects IgAV outcomes in adolescents.
Methods
Demographic, clinical, and laboratory data of 333 patients diagnosed with IgAV at the Department of Pediatric Rheumatology, University of Health Sciences, Ankara City Hospital, were evaluated retrospectively. The patients were classified into two groups: preadolescents (<10 years) and adolescents (10–19 years). Subgroup analyses were also performed by grouping the adolescent patients into early, middle, and late adolescent groups.
Results
Of the 333 patients, 219 (65.8%) and 114 (34.2%) were preadolescents and adolescents. Palpable purpura, renal, joint, and gastrointestinal (GI) tract involvement were detected in 333 (100%), 78 (23.4%), 79 (23.7%), and 124 (37.2%) patients, respectively; testicular involvement was observed in 25 (13.3%) of 187 male patients. The frequency of renal involvement was significantly higher in the adolescent group than in the preadolescent group at the time of diagnosis (p = 0.030). Notably, joint involvement was significantly higher in the adolescent group (p = 0.001). The need for aggressive therapy was significantly higher in the adolescent group than in the preadolescent group (p = 0.003). There was no significant difference in clinical data, demographic characteristics, and laboratory findings between the adolescent subgroups (p > 0.05).
Conclusions
Immunoglobulin A vasculitis can occur at any age but the disease prognosis appears to worsen with age. The present study reported that joint involvement, kidney involvement, and the need for more aggressive treatment were higher in the adolescent group than in the preadolescent group.