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Risk factors for gastrointestinal bleeding in children with Henoch-Schönlein purpura
Dequan Su1, Mi Yang2, Xiaoqin Wang1
1Department of Nephrology, Xiamen Hospital, Affiliated Children's Hospital of Fudan University (Xiamen Children's Hospital), Xiamen, China.
Insights
Abdominal pain, elevated procalcitonin (PCT), and increased D-dimer levels are key risk factors for gastrointestinal bleeding in children with Henoch-Schönlein purpura (HSP). Early identification of these indicators aids in timely diagnosis and improved patient outcomes.
Area of Science:
- Pediatric Gastroenterology
- Rheumatology
- Hematology
Background:
- Henoch-Schönlein purpura (HSP) is a common vasculitis in children.
- Gastrointestinal (GI) bleeding is a significant complication of HSP, impacting patient morbidity.
- Identifying risk factors for GI bleeding in pediatric HSP is crucial for timely intervention.
Purpose of the Study:
- To investigate the risk factors associated with gastrointestinal bleeding in pediatric patients diagnosed with Henoch-Schönlein purpura.
- To improve early diagnosis, treatment strategies, and patient outcomes for HSP-related GI complications.
Main Methods:
- A case-control study comparing 23 pediatric patients with HSP and GI bleeding to 44 patients with HSP without GI bleeding.
- Data collection included clinical characteristics, laboratory results, and imaging findings.
- Univariate and multivariate analyses were performed to identify independent risk factors.
Main Results:
- Abdominal pain and intestinal wall thickening on ultrasonography were more frequent in the GI bleeding group (P < 0.05).
- Significant differences were observed in eight laboratory parameters, including WBC, NE, NLR, PCT, CRP, D-dimer, Fib, and TT (P < 0.05).
- Multivariate analysis identified abdominal pain (OR=2.334), PCT > 0.12 ng/ml (OR=10.010), and D-dimer > 1.87 mg/L (OR=3.407) as independent risk factors for GI bleeding.
Conclusions:
- Abdominal pain, elevated procalcitonin (PCT), and increased D-dimer levels are significant independent risk factors for gastrointestinal bleeding in pediatric HSP.
- Monitoring these indicators can enhance clinical management and improve outcomes for children with HSP.
- Early recognition of these risk factors facilitates prompt treatment and complication prevention.
Objective:
To analyze the risk factors associated with gastrointestinal bleeding in pediatric patients with Henoch-Schönlein purpura (HSP), with the goal of enhancing early diagnosis and treatment, preventing complications, and improving patient outcomes.
Methods:
The study involved 23 pediatric patients with HSP who experienced gastrointestinal bleeding, forming the study group. They were admitted to our hospital from June 2023 to June 2024. For comparison, a control group composed of 44 children with HSP but without gastrointestinal bleeding, admitted during the same timeframe, was established. Data on clinical characteristics, laboratory results, and imaging findings were collected. Both univariate and multivariate analyses were conducted to identify potential risk factors.
Results:
A total of 67 children with HSP were divided into two groups: those with gastrointestinal bleeding (23 cases) and those without (44 cases). The occurrence of abdominal pain and incidence of intestinal wall thickening detected by gastrointestinal ultrasonography were significantly higher in the group with gastrointestinal bleeding compared to the group without bleeding (P < 0.05). Univariate analysis revealed significant differences in eight laboratory parameters (WBC, NE, NLR, PCT, CRP, D-dimer, Fib, TT), all statistically significant (P < 0.05). Multivariate analysis identified three independent risk factors for gastrointestinal bleeding in children with HSP: abdominal pain (OR = 2.334, 95% CI: 0.458-11.886, P = 0.010), a PCT level above 0.12 ng/ml (OR = 10.010, 95% CI: 1.208-82.929, P = 0.033), and a D-dimer level exceeding 1.87 mg/L (OR = 3.407, 95% CI: 1.022-17.473, P < 0.001).
Conclusion:
The findings confirmed that abdominal pain, elevated PCT levels, and increased D-dimer are significant independent risk factors for gastrointestinal bleeding in pediatric patients with Henoch-Schönlein purpura. Clinicians should monitor these indicators attentively to enhance patient management and outcomes.
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