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Risk factors for intussusception in children with Henoch-Schönlein purpura: A case-control study
Qian Zhao1, Yan Yang2, Song-Wei He1
1Traditional Chinese Medicine Department, National Children's Medical Center, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing 100045, China.
Insights
Age at onset, delayed glucocorticoid therapy, hematochezia, and elevated D-dimer levels are key risk factors for intussusception in children with Henoch-Schönlein purpura (HSP) and gastrointestinal involvement.
Area of Science:
- Pediatric Gastroenterology
- Rheumatology
- Clinical Research
Background:
- The exact causes of Henoch-Schönlein purpura (HSP) leading to intussusception are not fully understood.
- Intussusception is a serious complication in children with HSP, particularly those with gastrointestinal (GI) symptoms.
Purpose of the Study:
- To identify and analyze the risk factors associated with intussusception in pediatric patients diagnosed with HSP and concurrent GI involvement.
- To provide a basis for early detection and intervention strategies.
Main Methods:
- A retrospective case-control study involving 60 children with HSP and intussusception and 100 children with HSP and GI involvement but without intussusception.
- Data collected included demographics, clinical presentation, laboratory results, and treatment details.
- Univariate and multiple logistic regression analyses were employed to determine independent risk factors.
Main Results:
- Independent risk factors for intussusception in pediatric HSP with GI involvement were identified as: age at onset, delayed initiation of glucocorticoid therapy (beyond 72 hours of GI symptoms), presence of hematochezia, and elevated D-dimer levels.
- Statistical significance was observed for these factors (P < 0.05).
Conclusions:
- The study identified four critical independent risk factors for intussusception in pediatric HSP patients with GI involvement.
- These findings serve as a valuable reference for the early prevention and timely treatment of this potentially life-threatening condition.
Background:
The etiology of Henoch-Schönlein purpura (HSP) with intussusception remains undefined.
Aim:
To investigate the risk factors for intussusception in children with HSP and gastrointestinal (GI) involvement.
Methods:
Sixty children with HSP and concomitant intussusception admitted to the Beijing Children's Hospital of Capital Medical University between January 2006 and December 2018 were enrolled in this study. One hundred pediatric patients with HSP and GI involvement but without intussusception, admitted to the same hospital during the same period, were randomly selected as a control group. The baseline clinical characteristics of all patients, including sex, age of onset, duration of disease, clinical manifestations, laboratory test results, and treatments provided, were assessed. Univariate and multiple logistic regression analyses were performed to identify possible risk factors.
Results:
The 60 children in the intussusception group comprised 27 girls (45%) and 33 boys (55%) and the 100 children in the non-intussusception group comprised 62 girls (62%) and 38 boys (38%). The median age of all patients were 6 years and 5 mo. Univariate and multiple regression analyses revealed age at onset, not receiving glucocorticoid therapy within 72 h of emergence of GI symptoms, hematochezia, and D-dimer levels as independent risk factors for intussusception in children with HSP (P < 0.05).
Conclusion:
The four independent risk factors for intussusception in pediatric HSP with GI involvement would be a reference for early prevention and treatment of this potentially fatal disease.
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