Skip to main content
SpringerLink
Log in

Correlations of Serological Markers with Development of Systemic Involvement in Adult Immunoglobulin A Vasculitis: A Retrospective Study of 259 Patients in Central China

  • Published:
Current Medical Science Aims and scope Submit manuscript

Abstract

Objective

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.

Methods

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.

Results

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.

Conclusion

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Heineke MH, Ballering AV, Jamin A, et al. New insights in the pathogenesis of immunoglobulin A vasculitis (Henoch-Schonlein purpura). Autoimmun Rev, 2017,16(12):1246–1253

    Article  CAS  Google Scholar 

  2. Hocevar A, Rotar Z, Ostrovrsnik J, et al. Incidence of IgA vasculitis in the adult Slovenian population. Br J Dermatol, 2014,171(3):524–527

    Article  CAS  Google Scholar 

  3. Kawasaki Y, Suyama K, Yugeta E, et al. The incidence and severity of Henoch-Schonlein purpura nephritis over a 22-year period in Fukushima Prefecture, Japan. Int Urol Nephrol, 2010,42(4):1023–1029

    Article  Google Scholar 

  4. Penny K, Fleming M, Kazmierczak D, et al. An epidemiological study of Henoch-Schonlein purpura. Paediatr Nurs, 2010,22(10):30–35

    Article  Google Scholar 

  5. Piram M, Mahr A. Epidemiology of immunoglobulin A vasculitis (Henoch-Schonlein): current state of knowledge. Curr Opin Rheumatol, 2013,25(2):171–178

    Article  CAS  Google Scholar 

  6. Piram M, Maldini C, Biscardi S, et al. Incidence of IgA vasculitis in children estimated by four-source capture-recapture analysis: a population-based study. Rheumatology (Oxford), 2017,56(8):1358–1366

    Article  Google Scholar 

  7. Hetland LE, Susrud KS, Lindahl K, et al. Henoch-Schönlein Purpura: A Literature Review. Acta Derm Venereol, 2017,97(10):1160–1166

    Article  CAS  Google Scholar 

  8. Nossent J, Raymond W, Keen H, et al. Hospitalisation rates and characteristics for adult and childhood immunoglobulin A vasculitis in Western Australia. Intern Med J, 2019,49(4):475–481

    Article  CAS  Google Scholar 

  9. Garcia-Porrua C, Calvino MC, Llorca J, et al. Henoch-Schonlein purpura in children and adults: clinical differences in a defined population. Semin Arthritis Rheum, 2002,32(3):149–156

    Article  Google Scholar 

  10. Kang Y, Park JS, Ha YJ, et al. Differences in clinical manifestations and outcomes between adult and child patients with Henoch-Schonlein purpura. J Korean Med Sci, 2014,29(2):198–203

    Article  Google Scholar 

  11. Hoeger PH. Prognostic parameters in Henoch-Schonlein purpura. Br J Dermatol, 2015,172(5):1191–1192

    Article  CAS  Google Scholar 

  12. Hong J, Yang HR. Laboratory markers indicating gastrointestinal involvement of henoch-schonlein purpura in children. Pediatr Gastroenterol Hepatol Nutr, 2015, 18(1):39–47

    Article  Google Scholar 

  13. St John J, Vedak P, Garza-Mayers AC, et al. Location of skin lesions in Henoch-Schonlein purpura and its association with significant renal involvement. J Am Acad Dermatol, 2018,78(1):115–120

    Article  Google Scholar 

  14. Hočevar A, Tomsic M, Jurcic V, et al. Predicting gastrointestinal and renal involvement in adult IgA vasculitis. Arthritis Res Ther, 2019,21(1):302

    Article  Google Scholar 

  15. Berthelot L, Jamin A, Viglietti D, et al. Value of biomarkers for predicting immunoglobulin A vasculitis nephritis outcome in an adult prospective cohort. Nephrol Dial Transplant, 2018,33(9):1579–1590

    CAS  PubMed  Google Scholar 

  16. Nagy GR, Kemeny L, Bata-Csorgo Z. Neutrophil-to-lymphocyte ratio: a biomarker for predicting systemic involvement in adult IgA vasculitis patients. J Eur Acad Dermatol Venereol, 2017,31(6):1033–1037

    Article  CAS  Google Scholar 

  17. Ozen S, Pistorio A, Iusan SM, et al. EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis, 2010,69(5):798–806

    Article  Google Scholar 

  18. Blanco R, Martinez-Taboada VM, Rodriguez-Valverde V, et al. Henoch-Schonlein purpura in adulthood and childhood: two different expressions of the same syndrome. Arthritis Rheum, 1997,40(5):859–864

    Article  CAS  Google Scholar 

  19. Yang YH, Wang SJ, Chuang YH, et al. The level of IgA antibodies to human umbilical vein endothelial cells can be enhanced by TNF-alpha treatment in children with Henoch-Schonlein purpura. Clin Exp Immunol, 2002, 130(2):352–357

    Article  CAS  Google Scholar 

  20. Suzuki H, Raska M, Yamada K, et al. Cytokines alter IgA1 O-glycosylation by dysregulating C1GalT1 and ST6GalNAc-II enzymes. J Biol Chem, 2014,289(8):5330–5339

    Article  CAS  Google Scholar 

  21. Wakai A, Gleeson A, Winter D. Role of fibrin D-dimer testing in emergency medicine. Emerg Med J, 2003, 20(4):319–325

    Article  CAS  Google Scholar 

  22. Ho CH. Can very high level of D-dimer exclusively predict the presence of thromboembolic diseases?. J Chin Med Assoc, 2011,74(4):151–154

    Article  CAS  Google Scholar 

  23. Han QX, Wang Y, Zhu HY, et al. A non-invasive diagnostic model of immunoglobulin A nephropathy and serological markers for evaluating disease severity. Chin Med J (Engl), 2019,132(6):647–652

    Article  Google Scholar 

  24. Wakabayashi I, Masuda H. Association of D-dimer with microalbuminuria in patients with type 2 diabetes mellitus. J Thromb Thrombolysis, 2009,27(1):29–35

    Article  CAS  Google Scholar 

  25. Domingueti CP, Foscolo RB, Dusse LMS, et al. Association of different biomarkers of renal function with D-dimer levels in patients with type 1 diabetes mellitus (renal biomarkers and D-dimer in diabetes). Arch Endocrinol Metab, 2018,62(1):27–33

    Article  Google Scholar 

  26. Zhao YL, Liu ZJ, Bai XM, et al. Obesity increases the risk of renal involvement in children with Henoch-Schonlein purpura. Eur J Pediatr, 2015,174(10):1357–1363

    Article  CAS  Google Scholar 

Download references

Author information

Author notes

  1. These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Dermatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Ying-li Nie, Ze-xing Song, Juan Tao & Liu Yang

  2. Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430015, China

    Ying-li Nie

  3. School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Xu Han

Authors
  1. Ying-li Nie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ze-xing Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Juan Tao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xu Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Liu Yang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Liu Yang.

Additional information

This study was supported by the National Natural Science Foundation of China (No. 81772913).

Conflict of Interest Statement

We have no conflicts of interest to declare.

Author Juan TAO is a member of the Editorial Board for Current Medical Science. The paper was handled by the other editors and has undergone rigorous peer review process. Author Juan TAO is not involved in the journal’s review of, or decisions related to, this manuscript.

Electronic Supplementary Material

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nie, Yl., Song, Zx., Tao, J. et al. Correlations of Serological Markers with Development of Systemic Involvement in Adult Immunoglobulin A Vasculitis: A Retrospective Study of 259 Patients in Central China. CURR MED SCI 41, 888–893 (2021). https://doi.org/10.1007/s11596-021-2440-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11596-021-2440-0

Key words

Search

Navigation