儿童IgA血管炎临床研究进展

doi:10.12372/jcp.2024.23e0251

Abstract

Abstract:

IgA vasculitis (IgAV) is an autoimmune disease caused by IgA deposition in small blood vessels. It is characterized by non-thrombocytopenic purpura, abdominal pain, joint swelling and pain, hematuria or proteinuria. The disease is self-limited, with only a minority progressing to end-stage renal disease in later life. This paper reviews the clinical features of IgAV in children and the mechanisms of renal involvement, and discusses the treatment and prognosis of the disease.

Key words: IgA vasculitis, Henoch-Schönlein purpura, purpura nephritis, child

CHAI Yahui, YANG Dasheng, ZHANG He, BI Lingyun. Progress of Clinical Research on IgA Vasculitis in Children[J].Journal of Clinical Pediatrics, 2024, 42(8): 737-740.

References 33

[1]	Heineke MH, Ballering AV, Jamin A, et al. New insights in the pathogenesis of immunoglobulin A vasculitis (Henoch-Schonlein purpura)[J]. Autoimmun Rev, 2017, 16(12): 1246-1253.
[2]	Leung AKC, Barankin B, Leong KF. Henoch-Schonlein purpura in children: an updated review[J]. Curr Pediatr Rev, 2020, 16(4): 265-276.
[3]	Pillebout E, Sunderkotter C. IgA vasculitis[J]. Semin Immunopathol, 2021, 43(5): 729-738. doi: 10.1007/s00281-021-00874-9 pmid: 34170395
[4]	Ulas T, Tursun I, Dal MS, et al. Rapid improvement of Henoch-Schonlein purpura associated with the treatment of Helicobacter pylori infection[J]. J Res Med Sci, 2012, 17(11): 1086-1088. pmid: 23833587
[5]	Jacobi M, Lancrei HM, Brosh-Nissimov T, et al. Purpurona: a novel report of COVID-19-related Henoch-Schonlein purpura in a child[J]. Pediatr Infect Dis J, 2021, 40(2): e93-e94.
[6]	Rasmussen C, Tisseyre M, Garon-Czmil J, et al. Drug-induced IgA vasculitis in children and adults: revisiting drug causality using a dual pharmacovigilance-based approach[J]. Autoimmun Rev, 2021, 20(1): 102707.
[7]	Hastings MC, Rizk DV, Kiryluk K, et al. IgA vasculitis with nephritis: update of pathogenesis with clinical implications[J]. Pediatr Nephrol, 2022, 37(4): 719-733.
[8]	Sestan M, Srsen S, Kifer N, et al. Persistence and severity of cutaneous manifestations in IgA vasculitis is associated with development of IgA vasculitis nephritis in children[J]. Dermatology, 2022, 238(2): 340-346.
[9]	Yamazaki T, Akimoto T, Iwazu Y, et al. Henoch-Schonlein purpura complicated with severe gastrointestinal bleeding[J]. CEN Case Rep, 2015, 4(1): 106-111.
[10]	Ozen S, Marks SD, Brogan P, et al. European consensus-based recommendations for diagnosis and treatment of immunoglobulin A vasculitis-the SHARE initiative[J]. Rheumatology (Oxford), 2019, 58(9): 1607-1616. doi: 10.1093/rheumatology/kez041 pmid: 30879080
[11]	Chan H, Tang YL, Lv XH, et al. Risk factors associated with renal involvement in childhood Henoch-Schönlein purpura: a meta-analysis[J]. PLoS One, 2016, 11(11): e0167346.
[12]	Wang K, Sun X, Cao Y, et al. Risk factors for renal involvement and severe kidney disease in 2731 Chinese children with Henoch-Schönlein purpura: a retrospective study[J]. Medicine (Baltimore), 2018, 97(38): e12520.
[13]	Di Pietro GM, Castellazzi ML, Mastrangelo A, et al. Henoch-Schönlein purpura in children: not only kidney but also lung[J]. Pediatr Rheumatol Online J, 2019, 17(1): 75.
[14]	Bucak A, Bükülmez A, Kuzu S, et al. Cochlear and vestibular involvement in children with IgA vasculitis[J]. Eur J Pediatr, 2022, 181(4): 1481-1486. doi: 10.1007/s00431-021-04331-5 pmid: 34993623
[15]	de Sousa-Pereira P, Woof JM. IgA: structure, function, and developability[J]. Antibodies (Basel), 2019, 8(4): 57.
[16]	Knoppova B, Reily C, Maillard N, et al. The origin and activities of IgA1-containing immune complexes in IgA nephropathy[J]. Front Immunol, 2016, 7: 117. doi: 10.3389/fimmu.2016.00117 pmid: 27148252
[17]	Suzuki H, Yasutake J, Makita Y, et al. IgA nephropathy and IgA vasculitis with nephritis have a shared feature involving galactose-deficient IgA1-oriented pathogenesis[J]. Kidney Int, 2018, 93(3): 700-705. doi: S0085-2538(17)30799-8 pmid: 29329643
[18]	Giannakakis K, Feriozzi S, Perez M, et al. Aberrantly glycosylated IgA1 in glomerular immune deposits of IgA nephropathy[J]. J Am Soc Nephrol, 2007, 18(12): 3139-3146. pmid: 17978312
[19]	Yuan L, Wang Q, Zhang S, et al. Correlation between serum inflammatory factors TNF-α, IL-8, IL-10 and Henoch-Schonlein purpura with renal function impairment[J]. Exp Ther Med, 2018, 15(4): 3924-3928. doi: 10.3892/etm.2018.5876 pmid: 29556266
[20]	Gregori S, Roncarolo MG. Engineered T regulatory type 1 cells for clinical application[J]. Front Immunol, 2018, 9: 233. doi: 10.3389/fimmu.2018.00233 pmid: 29497421
[21]	Wang BX, Mei H, Peng HM, et al. Association between platelet-activating factor acetylhydrolase gene polymorphisms and gastrointestinal bleeding in children with Henoch-Schönlein purpura[J]. Zhongguo Dang Dai Er Ke Za Zhi, 2017, 19(4): 385-388.
[22]	López-Mejías R, Castañeda S, Genre F, et al. Genetics of immunoglobulin-A vasculitis (Henoch-Schönlein purpura): an updated review[J]. Autoimmun Rev, 2018, 17(3): 301-315. doi: S1568-9972(18)30012-0 pmid: 29353097
[23]	Khajoee V, Kariyazono H, Ohno T, et al. Inducible and endothelial constitutive nitric oxide synthase gene polymorphisms in Kawasaki disease[J]. Pediatr Int, 2003, 45(2): 130-134. doi: 10.1046/j.1442-200x.2003.01684.x pmid: 12709136
[24]	Jiang J, Duan W, Shang X, et al. Inducible nitric oxide synthase gene polymorphisms are associated with a risk of nephritis in Henoch-Schonlein purpura children[J]. Eur J Pediatr, 2017, 176(8): 1035-1045. doi: 10.1007/s00431-017-2945-5 pmid: 28593405
[25]	Amoli MM, Thomson W, Hajeer AH, et al. Interleukin 1 receptor antagonist gene polymorphism is associated with severe renal involvement and renal sequelae in Henoch-Schönlein purpura[J]. J Rheumatol, 2002, 29(7): 1404-1407. pmid: 12136897
[26]	Balcı-Peynircioğlu B, Kaya-Akça Ü, Arıcı ZS, et al. Comorbidities in familial Mediterranean fever: analysis of 2000 genetically confirmed patients[J]. Rheumatology (Oxford), 2020, 59(6): 1372-1380. doi: 10.1093/rheumatology/kez410 pmid: 31598713
[27]	López-Mejías R, Genre F, Pérez BS, et al. HLA-DRB1 association with Henoch-Schonlein purpura[J]. Arthritis Rheumatol, 2015, 67(3): 823-827.
[28]	López-Mejías R, Carmona FD, Castañeda S, et al. A genome-wide association study suggests the HLA Class II region as the major susceptibility locus for IgA vasculitis[J]. Sci Rep, 2017, 7(1): 5088.
[29]	Rovin BH, Adler SG, Barratt J, et al. Executive summary of the KDIGO 2021 guideline for the management of glomerular diseases[J]. Kidney Int, 2021, 100(4): 753-779. doi: 10.1016/j.kint.2021.05.015 pmid: 34556300
[30]	Szemenyei C, Hahn D. Prevention of nephritis in Henoch-Schonlein purpura[J]. J Paediatr Child Health, 2015, 51(2): 236-239.
[31]	Hou L, Zhang Z, Du Y. Leflunomide therapy for IgA vasculitis with nephritis in children[J]. BMC Pediatr, 2021, 21(1): 391.
[32]	Nagelkerke SQ, Dekkers G, Kustiawan I, et al. Inhibition of FcγR-mediated phagocytosis by IVIg is independent of IgG-Fc sialylation and FcγRIIb in human macrophages[J]. Blood, 2014, 124(25): 3709-3718. doi: 10.1182/blood-2014-05-576835 pmid: 25352126
[33]	Crayne CB, Eloseily E, Mannion ML, et al. Rituximab treatment for chronic steroid-dependent Henoch-Schonlein purpura: 8 cases and a review of the literature[J]. Pediatr Rheumatol Online J, 2018, 16(1): 71.

Progress of Clinical Research on IgA Vasculitis in Children

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