Clinical features and gastrointestinal bleeding risk factors in IgA vasculitis patients: a retrospective study in a
Jinxi Zhao1, Xiaohong Wang2, Ruiheng Xie1
1Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China.
Objectives:
Gastrointestinal (GI) bleeding is a serious complication of immunoglobulin A vasculitis (IgAV), but reliable predictors are still lacking. This study aimed to identify clinical risk factors and develop a prediction model for IgAV-related GI bleeding in a large patient cohort.
Methods:
In this retrospective study, 968 patients with IgAV from the Affiliated Hospital of Southwest Medical University (2019-2024) were divided into GI bleeding (n=484) and non-bleeding (n=484) groups. We analysed seasonal onset patterns and used multivariate logistic regression with ROC curve validation to identify predictors.
Results:
This retrospective study revealed that summer-onset disease was associated with a significantly higher risk of GI bleeding compared to other seasons (OR=1.67, 95% CI:1.15-2.45; p=0.007), representing a 13.8% absolute risk increase (p<0.001). The neutrophil-to-albumin ratio (NAR) was the strongest biochemical predictor (OR=1.79; 95% CI:1.33-2.47; AUC=0.723). High systemic immune-inflammation index levels also increased risk (OR=2.91, 95% CI:1.67-5.08), while mean platelet volume (MPV) was protective (OR=0.78, 95% CI:0.68-0.90). A combined model including seasonality, NAR, and MPV showed superior predictive performance (AUC=0.742, 95% CI:0.711-0.772).
Conclusions:
Summer onset, elevated NAR, and decreased MPV help identify IgAV patients at high risk of GI bleeding. A model combining these factors allows effective risk stratification and supports targeted monitoring in clinical practice, particularly for summer-admitted patients with high neutrophil-to-albumin ratios.
Related Concept Videos
01:28Esophageal Varices-II: Clinical Features and Management
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol abuse, or...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:23Gastritis III: Clinical Manifestations and Management
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...
01:24Esophageal Varices-I: Introduction
01:20Inflammatory Bowel Disease IV: Clinical Manifestations
01:30Irritable Bowel Syndrome II: Clinical Features and Diagnostic Evaluation
Irritable Bowel Syndrome (IBS) is classified into subtypes based on the predominant bowel habits as determined by the Bristol Stool Form Scale (BSFS). The subtypes are: