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IgA Vaskuliti Tanılı Olgularda Klinik ve Hematolojik Parametrelerin İlişkisi

Year 2020, Volume: 18 Issue: 3, 390 - 402, 18.12.2020

Arife Uslu Gökceoğlu Meliha Sevim , Sema Nilay Abseyi

Abstract

GİRİŞ ve AMAÇ: IgA vaskuliti, çocukluk çağında en sık görülen vaskulit olmakla birlikte; gastrointestinal sistem ve renal tutulum olması hastalık seyrini etkilemektedir. Bu nedenle bu çalışmanın amacı retrospektif olarak başvuru anındaki hematolojik parametreler ile klinik bulgular ve organ tutulumu arasındaki ilişkiyi değerlendirmektir

YÖNTEM ve GEREÇLER: Çocuk Nefroloji Polikliniğinde IgA vaskuliti (HSP) tanısı alan çocuklar çalışmaya dahil edildi. Hastaların demografik bilgileri, klinik bulguları, laboratuar sonuçları ve ultrasonografi sonuçları kayıt edildi. Başvuru sırasındaki lökosit sayısı, trombosit sayısı, ortalama trombosit hacmi (MPV), eritrosit dağılım genişliği (RDW), total nötrofil sayısı, total lenfosit sayısı, sedimentasyon, C-reaktif protein (CRP), tam idrar tetkiki sonucunda hematüri ve/veya proteinüri varlığı, böbrek fonksiyon testleri ve ultrasonografi sonuçları kayıt edildi. Nötrofil/lenfosit oranı manuel hesaplandı.

BULGULAR: Olguların %73’de eklem tutulumu, %52 ‘de organ tutulumu, %35’inde gastrointestinal sistem tutulumu, %20’de renal tutulum izlendi. Organ tutulumu olanlarda ve gastrointestinal sistem tutulumu olanlarda ortalama nötrofil ve nötrofil/lenfosit oranı anlamlı yüksek bulundu. Renal tutulumu olanlarda ortalama nötrofil sayısı, RDW ve CRP değerleri anlamlı yüksekti. Renal tutulum için erkek cinsiyet ve RDW değeri risk faktörü olarak saptandı.

TARTIŞMA ve SONUÇ: IgA vaskulitinde başvurudaki hematolojik parametreler hastaların organ tutulumu, gastrointestinal sistem tutulumu ve renal tutulum açısından riskli olguları belirleyici olabilir. Özellikle nötrofil/lenfosit oranının organ tutulumu, gastrointestinal sistem tutulumu ve renal tutulumu olan olgularda daha yüksek olması hastalık patogenezinde nötrofillerin rolü olduğunu desteklemektedir. Renal tutulum için erkek cinsiyet ve artmış RDW değeri risk faktörleridir.

Keywords

Henosch Schönlein Purpurası IgA vaskuliti C reaktif protein nötrofil,

References

  • 1- Barut K, Şahin S, Adroviç A, Kasapçopur Ö. [Diagnostic approach and current treatment options in childhood vasculitis ]Turk Pediatri Ars 2015; 50: 194-205.
  • 2-Ardoin SP, Fels E. Henoch-Schönlein purpura. In: Kliegman RM, Stanton BMD, Geme J, Schor N, Behrman RE, eds. Nelson Textbook of Pediatrics, 19th ed. Philadelphia, PA: WBSaunders; 2011:868–71.
  • 3-Sano H, Izumida M, Shimizu H, et al. Risk factors of renal involvement and significant proteinuria in Henoch-Schönlein purpura. Eur J Pediatr. 2002;161:196–201
  • 4- Özdemir Z, Çetin N, Kar Y, Öcal H, Bilgin M, Bör Ö. Hemotological Indices for Predicting for Internal Organ Involvement in Henosch Schönlein Purpura. J Pediatr Hematol Oncol 2020;42:e46–e49
  • 5-Ozen S, Pistorio A, Iusan SM, Bakkaloglu A, Herlin T, Brik R, et al. Paediatric Rheumatology International Trials Organisation (PRINTO). EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis 2010;69:798- 806
  • 6-Oni L, Sampath S. Childhood IgA Vasculitis (Henoch Schonlein Purpura)-Advances and Knowledge Gaps. Fronth Pediatr 2019 Jun 27;7:257.
  • 7-Özçakar Ö, Fitöz S, Yalçınkaya F. [Childhood Vasculitis]. Klinik Gelişim Dergisi. 2006; 19:52-5
  • 8-Garcia-Porrua C, Calvino MC, Llorca J, Couselo JM, Gonzalez Gay MA. Henoch Schönlein purpura in children and adults: clinical differences in a defined population. Semin Arthritis Rheum 2002; 32:149- 56.
  • 9-Calvino MC, Liorca J, Garcia-Porrua C, Fernandez-Iglesias JL, Rodriguez-Ledo P, GonzalezGay MA. Henoch-Schönlein purpura in children from Northwestern Spain: a 20-year epidemiologic and clinical study. Medicine (Baltimore) 2001; 80:279-90
  • 10- Candemir M, Halis H, Polat A, Ergin H, Kılıç İ, Semiz S, ve ark. [Analysis of Patients With Henoch-Schonlein purpura]. ADÜ Tıp Fakültesi Dergisi 2006; 7: 39-43.
  • 11- İnal A, Yılmaz M, Kendirli SG, Altıntaş DU, Karakoç GB, Doğruel D. Henoch-Schonlein purpurası tanısı alan çocukların klinik özellikleri. Erciyes Tıp Dergisi 2009; 31:153-61
  • 12-Trapani S, Micheli A, Grisolia F, Resti M, Chiappini E, Falcini F, et al. Henoch-Schönlein Purpura in childhood: epidemiological and clinical analysis of 150 cases over a 5-year period and review of literature. Semin Arthritis Rheum. 2005 Dec;35(3):143-53.
  • 13- Trnka P.Henoch–Schönlein purpura in children. J Paediatr Child Health.2013 Dec;49(12):995-1003. doi: 10.1111/jpc.12403. Epub 2013 Oct 18
  • 14-Özel A, Bostan Gayret Ö, Erol M, Yiğit Ö, Mete F. Are mean platelet volume and neutrophil to lymphocyte ratio valuable in the early detection of system involvements in henoch schönlein purpura? Med Bull Haseki 2018;56:279-85
  • 15- Hui Xu, BSa , Wei Li, MSa , Jian-hua Mao, MD, PhDb , Yan-xiang Pan, MS . Association between red blood cell distribution width and Henoch–Schonlein purpura nephritis.Medicine (Baltimore) 2007;Jun;96(23):e7091. doi: 10.1097/MD.0000000000007091
  • 16-Salvagno GL , Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci 2015;52(2):86-105. doi: 10.3109/10408363.2014.992064. Epub 2014 Dec 23.
  • 17-Heineke MH, Ballering AV, Jamin A, ET AL. New insights in the pathogenesis of immunoglobulin A vasculitis. Autoimmun rev. 2017;16: 1246-53)
  • 18-Ozen S, Bakkaloglu A, Dusunsel R, Soylemezoglu O, Ozaltin F, Poyrazoglu H, Kasapcopur O, Ozkaya O, Yalcinkaya F, Balat A, Kural N, Donmez O, Alpay H, Anarat A, Mir S, Gur-Guven A, Sonmez F, Gok F, Turkish Pediatric Vasculitis Study G (2007) Childhood vasculitides in Turkey: a nationwide survey. Clin Rheumatol 26(2):196–200. https://doi.org/10.1007/s10067-006-0266-64.
  • 19-Lippl F, Huber W, Werner M, Nekarda H, Berger H, Weigert N. Life-threatening gastrointestinal bleeding due to a jejunal lesion of Henoch-Schonlein purpura. Endoscopy 2001;33(9):811–13. https://doi.org/10.1055/s-2001-16529
  • 20-Hong SH, Kim CJ, Yang EM. Neutrophil-to-lymphocyte ratio to predict gastrointestinal bleeding in Henoch: Schönlein purpura. Pediatr Int 2018 Sep;60(9):791-95. doi: 10.1111/ped.13652. Epub 2018 Sep 5.
  • 21-Makay B, Gücenmez ÖA, Duman M, Ünsal E. The relationship of neutrophil-to-lymphocyte ratio with gastrointestinal bleeding in Henoch-Schonlein purpura.-. Rheumatol Int 2014 Sep;34(9):1323-7. doi: 10.1007/s00296-014-2986-2. Epub 2014 Mar 20.
  • 22-Jeong YK, Ha HK, Yoon CH, Gong G, Kim PN, Lee MG, et al. Gastrointestinal involvement in Henoch-Schönlein syndrome: CT findings. Am J Roentgenol 1997;168:965-8.
  • 23-Couture A, Veyrac C, Baud C, Galifer RB, Armelin I. Evaluation of abdominal pain in Henoch-Schönlein syndrome by high frequency ultrasound. Pediatr Radiol 1992;22:12-7.
  • 24-Dönmez O, Yıldırım NS, Durmaz O. Henoch Schonlein Purpuralı 137 olgunun 10 yıllık retrospektif değerlendirilmesi. Güncel Pediatri Dergisi 2011; 9:63-7.
  • 25-Kawasaki Y, Suzuki H: Henoch-Schönlein Nephritis, In: Geary DF, Schaefer F (Eds): Comphrehensive Pediatric Nephrology. 1st edition, Mosby Elsevier, Philadelphia 2008: 343-53) .
  • 26-Anil M, Aksu N, Kara OD, Bal A, Anil AB, Yavascan O et al. Henoch-Schonlein purpura in children from western Turkey: a retrospective analysis of 430 cases. Turk J Pediatr 2009; 51: 429-36
  • 27- Mao Y, Yin L, Huang H, Zhou Z, Chen T, Zhou W. HenochSchonlein purpura in 535 Chinese children: clinical features and risk factors for renal involvement. J Int Med Res 2014; 42: 1043-9.)
  • 28-Danese E, Lippi G, Montagnana M. Red blood cell distribution width and cardiovascular disease. J Thorac Dis 2015;7:E402–11. [8] Xu WS, Qiu XM, Ou QS, et al. Red blood cell distribution width levels correlated with liver fibrosis and inflammation: a noninvasive serum marker panel to predict the severity of fibrosis and inflammation in patients with hepatitis B. Medicine (Baltimore) 2015;94:e612.
  • 29- Xu WS, Qiu XM, Ou QS, et al. Red blood cell distribution width levels correlated with liver fibrosis and inflammation: a noninvasive serum marker panel to predict the severity of fibrosis and inflammation in patients with hepatitis B. Medicine (Baltimore) 2015;94:e612.
  • 30- Oh HJ, Park JT, Kim JK, et al. Red blood cell distribution width is an independent predictor of mortality in acute kidney injury patients treated with continuous renal replacement therapy. Nephrol Dial Transplant 2012;24:589–94
  • 31-Kim CH, Park JT, Kim EJ, et al. An increase in red blood cell distribution width from baseline predicts mortality in patients with severe sepsis or septic shock. Crit Care 2013;17:R282.
  • 32- Song CS, Park DI, Yoon MY, et al. Association between red cell distribution width and disease activity in patients with inflammation bowel disease. Dig Dis Sci 2012;57:1033–8.
  • 33- Bozlu G, Taskinlar H, Unal S, et al. Diagnostic value of red blood cell distribution width in pediatric acute appendicitis. Pediatr Int 2016;58:202–5
  • 34-Zhu X, Zhang M, Lan F, Wei H, He Q ,Li S, Qin X. The relationship between red cell distribution width and the risk of Henoch-Schönlein purpura nephritis. Br J Biomed Sci 2018; Jan;75(1):30-5.
  • 35- Teng X, Wang Y, Lin N, Sun M, Wu J. Evaluation of serum procalcitonin and C-reactive protein levels as biomarkers of Henoch-Schönlein purpura in pediatric patients . Clin Rheumatol 2016 Mar;35(3):667-71

Year 2020, Volume: 18 Issue: 3, 390 - 402, 18.12.2020

Arife Uslu Gökceoğlu Meliha Sevim , Sema Nilay Abseyi

Abstract

References

  • 1- Barut K, Şahin S, Adroviç A, Kasapçopur Ö. [Diagnostic approach and current treatment options in childhood vasculitis ]Turk Pediatri Ars 2015; 50: 194-205.
  • 2-Ardoin SP, Fels E. Henoch-Schönlein purpura. In: Kliegman RM, Stanton BMD, Geme J, Schor N, Behrman RE, eds. Nelson Textbook of Pediatrics, 19th ed. Philadelphia, PA: WBSaunders; 2011:868–71.
  • 3-Sano H, Izumida M, Shimizu H, et al. Risk factors of renal involvement and significant proteinuria in Henoch-Schönlein purpura. Eur J Pediatr. 2002;161:196–201
  • 4- Özdemir Z, Çetin N, Kar Y, Öcal H, Bilgin M, Bör Ö. Hemotological Indices for Predicting for Internal Organ Involvement in Henosch Schönlein Purpura. J Pediatr Hematol Oncol 2020;42:e46–e49
  • 5-Ozen S, Pistorio A, Iusan SM, Bakkaloglu A, Herlin T, Brik R, et al. Paediatric Rheumatology International Trials Organisation (PRINTO). EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis 2010;69:798- 806
  • 6-Oni L, Sampath S. Childhood IgA Vasculitis (Henoch Schonlein Purpura)-Advances and Knowledge Gaps. Fronth Pediatr 2019 Jun 27;7:257.
  • 7-Özçakar Ö, Fitöz S, Yalçınkaya F. [Childhood Vasculitis]. Klinik Gelişim Dergisi. 2006; 19:52-5
  • 8-Garcia-Porrua C, Calvino MC, Llorca J, Couselo JM, Gonzalez Gay MA. Henoch Schönlein purpura in children and adults: clinical differences in a defined population. Semin Arthritis Rheum 2002; 32:149- 56.
  • 9-Calvino MC, Liorca J, Garcia-Porrua C, Fernandez-Iglesias JL, Rodriguez-Ledo P, GonzalezGay MA. Henoch-Schönlein purpura in children from Northwestern Spain: a 20-year epidemiologic and clinical study. Medicine (Baltimore) 2001; 80:279-90
  • 10- Candemir M, Halis H, Polat A, Ergin H, Kılıç İ, Semiz S, ve ark. [Analysis of Patients With Henoch-Schonlein purpura]. ADÜ Tıp Fakültesi Dergisi 2006; 7: 39-43.
  • 11- İnal A, Yılmaz M, Kendirli SG, Altıntaş DU, Karakoç GB, Doğruel D. Henoch-Schonlein purpurası tanısı alan çocukların klinik özellikleri. Erciyes Tıp Dergisi 2009; 31:153-61
  • 12-Trapani S, Micheli A, Grisolia F, Resti M, Chiappini E, Falcini F, et al. Henoch-Schönlein Purpura in childhood: epidemiological and clinical analysis of 150 cases over a 5-year period and review of literature. Semin Arthritis Rheum. 2005 Dec;35(3):143-53.
  • 13- Trnka P.Henoch–Schönlein purpura in children. J Paediatr Child Health.2013 Dec;49(12):995-1003. doi: 10.1111/jpc.12403. Epub 2013 Oct 18
  • 14-Özel A, Bostan Gayret Ö, Erol M, Yiğit Ö, Mete F. Are mean platelet volume and neutrophil to lymphocyte ratio valuable in the early detection of system involvements in henoch schönlein purpura? Med Bull Haseki 2018;56:279-85
  • 15- Hui Xu, BSa , Wei Li, MSa , Jian-hua Mao, MD, PhDb , Yan-xiang Pan, MS . Association between red blood cell distribution width and Henoch–Schonlein purpura nephritis.Medicine (Baltimore) 2007;Jun;96(23):e7091. doi: 10.1097/MD.0000000000007091
  • 16-Salvagno GL , Sanchis-Gomar F, Picanza A, Lippi G. Red blood cell distribution width: A simple parameter with multiple clinical applications. Crit Rev Clin Lab Sci 2015;52(2):86-105. doi: 10.3109/10408363.2014.992064. Epub 2014 Dec 23.
  • 17-Heineke MH, Ballering AV, Jamin A, ET AL. New insights in the pathogenesis of immunoglobulin A vasculitis. Autoimmun rev. 2017;16: 1246-53)
  • 18-Ozen S, Bakkaloglu A, Dusunsel R, Soylemezoglu O, Ozaltin F, Poyrazoglu H, Kasapcopur O, Ozkaya O, Yalcinkaya F, Balat A, Kural N, Donmez O, Alpay H, Anarat A, Mir S, Gur-Guven A, Sonmez F, Gok F, Turkish Pediatric Vasculitis Study G (2007) Childhood vasculitides in Turkey: a nationwide survey. Clin Rheumatol 26(2):196–200. https://doi.org/10.1007/s10067-006-0266-64.
  • 19-Lippl F, Huber W, Werner M, Nekarda H, Berger H, Weigert N. Life-threatening gastrointestinal bleeding due to a jejunal lesion of Henoch-Schonlein purpura. Endoscopy 2001;33(9):811–13. https://doi.org/10.1055/s-2001-16529
  • 20-Hong SH, Kim CJ, Yang EM. Neutrophil-to-lymphocyte ratio to predict gastrointestinal bleeding in Henoch: Schönlein purpura. Pediatr Int 2018 Sep;60(9):791-95. doi: 10.1111/ped.13652. Epub 2018 Sep 5.
  • 21-Makay B, Gücenmez ÖA, Duman M, Ünsal E. The relationship of neutrophil-to-lymphocyte ratio with gastrointestinal bleeding in Henoch-Schonlein purpura.-. Rheumatol Int 2014 Sep;34(9):1323-7. doi: 10.1007/s00296-014-2986-2. Epub 2014 Mar 20.
  • 22-Jeong YK, Ha HK, Yoon CH, Gong G, Kim PN, Lee MG, et al. Gastrointestinal involvement in Henoch-Schönlein syndrome: CT findings. Am J Roentgenol 1997;168:965-8.
  • 23-Couture A, Veyrac C, Baud C, Galifer RB, Armelin I. Evaluation of abdominal pain in Henoch-Schönlein syndrome by high frequency ultrasound. Pediatr Radiol 1992;22:12-7.
  • 24-Dönmez O, Yıldırım NS, Durmaz O. Henoch Schonlein Purpuralı 137 olgunun 10 yıllık retrospektif değerlendirilmesi. Güncel Pediatri Dergisi 2011; 9:63-7.
  • 25-Kawasaki Y, Suzuki H: Henoch-Schönlein Nephritis, In: Geary DF, Schaefer F (Eds): Comphrehensive Pediatric Nephrology. 1st edition, Mosby Elsevier, Philadelphia 2008: 343-53) .
  • 26-Anil M, Aksu N, Kara OD, Bal A, Anil AB, Yavascan O et al. Henoch-Schonlein purpura in children from western Turkey: a retrospective analysis of 430 cases. Turk J Pediatr 2009; 51: 429-36
  • 27- Mao Y, Yin L, Huang H, Zhou Z, Chen T, Zhou W. HenochSchonlein purpura in 535 Chinese children: clinical features and risk factors for renal involvement. J Int Med Res 2014; 42: 1043-9.)
  • 28-Danese E, Lippi G, Montagnana M. Red blood cell distribution width and cardiovascular disease. J Thorac Dis 2015;7:E402–11. [8] Xu WS, Qiu XM, Ou QS, et al. Red blood cell distribution width levels correlated with liver fibrosis and inflammation: a noninvasive serum marker panel to predict the severity of fibrosis and inflammation in patients with hepatitis B. Medicine (Baltimore) 2015;94:e612.
  • 29- Xu WS, Qiu XM, Ou QS, et al. Red blood cell distribution width levels correlated with liver fibrosis and inflammation: a noninvasive serum marker panel to predict the severity of fibrosis and inflammation in patients with hepatitis B. Medicine (Baltimore) 2015;94:e612.
  • 30- Oh HJ, Park JT, Kim JK, et al. Red blood cell distribution width is an independent predictor of mortality in acute kidney injury patients treated with continuous renal replacement therapy. Nephrol Dial Transplant 2012;24:589–94
  • 31-Kim CH, Park JT, Kim EJ, et al. An increase in red blood cell distribution width from baseline predicts mortality in patients with severe sepsis or septic shock. Crit Care 2013;17:R282.
  • 32- Song CS, Park DI, Yoon MY, et al. Association between red cell distribution width and disease activity in patients with inflammation bowel disease. Dig Dis Sci 2012;57:1033–8.
  • 33- Bozlu G, Taskinlar H, Unal S, et al. Diagnostic value of red blood cell distribution width in pediatric acute appendicitis. Pediatr Int 2016;58:202–5
  • 34-Zhu X, Zhang M, Lan F, Wei H, He Q ,Li S, Qin X. The relationship between red cell distribution width and the risk of Henoch-Schönlein purpura nephritis. Br J Biomed Sci 2018; Jan;75(1):30-5.
  • 35- Teng X, Wang Y, Lin N, Sun M, Wu J. Evaluation of serum procalcitonin and C-reactive protein levels as biomarkers of Henoch-Schönlein purpura in pediatric patients . Clin Rheumatol 2016 Mar;35(3):667-71
There are 35 citations in total.

Details

Primary Language Turkish
Subjects ​Internal Diseases
Journal Section Research Article
Authors

Arife Uslu Gökceoğlu This is me 0000-0002-5331-0315

Meliha Sevim 0000-0002-9948-2972

Sema Nilay Abseyi This is me 0000-0002-0303-6274

Publication Date December 18, 2020
Published in Issue Year 2020 Volume: 18 Issue: 3

Cite

APA Uslu Gökceoğlu, A., Sevim, M., & Abseyi, S. N. (n.d.). IgA Vaskuliti Tanılı Olgularda Klinik ve Hematolojik Parametrelerin İlişkisi. Güncel Pediatri, 18(3), 390-402. https://doi.org/10.32941/pediatri.841439
AMA Uslu Gökceoğlu A, Sevim M, Abseyi SN. IgA Vaskuliti Tanılı Olgularda Klinik ve Hematolojik Parametrelerin İlişkisi. Güncel Pediatri. 18(3):390-402. doi:10.32941/pediatri.841439
Chicago Uslu Gökceoğlu, Arife, Meliha Sevim, and Sema Nilay Abseyi. “IgA Vaskuliti Tanılı Olgularda Klinik Ve Hematolojik Parametrelerin İlişkisi”. Güncel Pediatri 18, no. 3 n.d.: 390-402. https://doi.org/10.32941/pediatri.841439.
EndNote Uslu Gökceoğlu A, Sevim M, Abseyi SN IgA Vaskuliti Tanılı Olgularda Klinik ve Hematolojik Parametrelerin İlişkisi. Güncel Pediatri 18 3 390–402.
IEEE A. Uslu Gökceoğlu, M. Sevim, and S. N. Abseyi, “IgA Vaskuliti Tanılı Olgularda Klinik ve Hematolojik Parametrelerin İlişkisi”, Güncel Pediatri, vol. 18, no. 3, pp. 390–402, doi: 10.32941/pediatri.841439.
ISNAD Uslu Gökceoğlu, Arife et al. “IgA Vaskuliti Tanılı Olgularda Klinik Ve Hematolojik Parametrelerin İlişkisi”. Güncel Pediatri 18/3 (n.d.), 390-402. https://doi.org/10.32941/pediatri.841439.
JAMA Uslu Gökceoğlu A, Sevim M, Abseyi SN. IgA Vaskuliti Tanılı Olgularda Klinik ve Hematolojik Parametrelerin İlişkisi. Güncel Pediatri.;18:390–402.
MLA Uslu Gökceoğlu, Arife et al. “IgA Vaskuliti Tanılı Olgularda Klinik Ve Hematolojik Parametrelerin İlişkisi”. Güncel Pediatri, vol. 18, no. 3, pp. 390-02, doi:10.32941/pediatri.841439.
Vancouver Uslu Gökceoğlu A, Sevim M, Abseyi SN. IgA Vaskuliti Tanılı Olgularda Klinik ve Hematolojik Parametrelerin İlişkisi. Güncel Pediatri. 18(3):390-402.