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

Author:

Acar Banu Ç1ORCID,Tekin Zahide E1ORCID,Güngörer Vildan1ORCID,Çelikel Elif1ORCID,Kurt Tuba1ORCID,Tekgöz Nilüfer1ORCID,Sezer Müge1ORCID,Karagöl Cüneyt1ORCID,Coşkun Serkan1ORCID,Kaplan Melike M1ORCID,Polat Merve C1ORCID,Öner Nimet1ORCID,Kuruç Aylin I2,Erten Elif E3ORCID,Şenel Emrah4

Affiliation:

1. Division of Pediatric Rheumatology, Department of Pediatrics University of Health Sciences, Ankara Bilkent City Hospital Ankara Turkey

2. Department of Pediatrics University of Health Sciences, Ankara Bilkent City Hospital Ankara Turkey

3. Department of Pediatric Surgery University of Health Sciences, Ankara Bilkent City Hospital Ankara Turkey

4. Department of Pediatric Surgery Ankara Yıldırım Beyazıt University, Ankara Bilkent City Hospital Ankara Turkey

Abstract

AimTo 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.MethodsThis 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.ResultsOne 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.ConclusionsThe 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.

Publisher

Wiley

Subject

Pediatrics, Perinatology and Child Health

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