Predictors of the late recurrences of immunoglobulin A vasculitis due to clinical and laboratory features in children

Objectives This study aims to evaluate the frequency and predictors of immunoglobulin A vasculitis (IgAV) late relapses based on clinical and laboratory features in children. Methods We retrospectively reviewed the medical records of IgAV patients. To assess the severity of the disease, the Pediatric Vasculitis Assessment Score (PVAS) was calculated for each patient during the initial visit. Late recurrence of IgAV was defined as the reappearance of skin lesions and/or systemic involvement after a symptom-free period of at least six months. Patients were divided into two subgroups: Group 1 consisted of IgAV patients who experienced at least one recurrence, while Group 2 included those with no recurrence. Results A total of 40 (7.3%) patients were in Group 1. Male gender, mean age at diagnosis, gastrointestinal and testicular involvement, WBC count, creatinine level, and pediatric vasculitis, PVAS at first visit were significantly higher in Group 1 than in Group 2 (p=0.033, p=0.015, p=0.047, p=0.003, p=0.012, p=0.012, and p=0.000, respectively). Male sex, diarrhea, testicular involvement, WBC value, and PVAS were found as independent risk factors to predict IgAV late recurrence (p=0.033, p=0.015, p=0.003, p=0.025, and p=0.005, respectively). Conclusions Close follow-up is essential, particularly in male patients and in the presence of testicular involvement, diarrhea, or a high PVAS at the initial visit, given the potential for late disease recurrence in the long term.