| Recurrent immunoglobulin A vasculitis in children and
adolescents: prevalence and associated risk factors |
Nootsara Atchariyaphuk1 
, Maynart Sukharomana2
, Thanaporn Chaiyapak3
, Sirirat Charuvanij2
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1Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok, Thailand
2Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok, Thailand
3Division of Nephrology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok, Thailand |
Correspondence:
Sirirat Charuvanij, Email: sirirat.chv@mahidol.ac.th
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Received: 25 May 2025 • Revised: 3 August 2025 • Accepted: 3 August 2025 |
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| Abstract |
Background
Immunoglobulin A vasculitis (IgAV) is a
systemic vasculitis characterized by potential recurrence.
Purpose
This study aimed to explore the prevalence of
and factors associated with IgAV recurrence. The clinical
phenotypes of childhood- and adolescent-onset IgAV
were described and compared.
Methods
This retrospective cohort analysis included
patients aged ≤18 years and diagnosed with IgAV treated
in a tertiary academic center between January 2010 and
December 2022. Recurrence was classified by the reappearance
of purpuric/petechiae or other features that
reappeared after at least 1 asymptomatic month.
Results
The 361 patients with IgAV had a mean age of
7.7±3.9 years; 53.2% of them were female. All patients with
IgAV exhibited skin manifestations. Gastrointestinal (GI)
and musculoskeletal (MSK) features were observed in 214
(59.3%) and 219 patients (60.7%), respectively. Renal involvement
was observed in 82 patients (22.7%). The prevalence
of childhood- and adolescent-onset IgAV was
269 (74.5%) and 92 (25.5%), respectively. Patients with
childhood-onset IgAV had significant GI manifestations
(P=0.01), had MSK features (P=0.002), and required hospitalization
(P=0.004). In contrast, patients with adolescentonset
IgAV had significant renal involvement (P<0.001)
and required a longer duration of corticosteroids treatment
(P<0.001). Of the study population, 119 patients (35.6
%) experienced recurrence. During the 12-month followup
period, 98 patients (27.1%) had recurrent IgAV at a
median 1.9 months (interquartile range, 1.2–4.8 months).
On the multivariable Cox proportional hazards regression
analysis, corticosteroids treatment was significantly
associated with IgAV recurrence (hazard ratio, 1.99; 95%
confidence interval, 1.266–3.157; P=0.003).
Conclusion
Renal involvement was more prevalent in
adolescent-onset IgAV, whereas MSK and GI involvement
were more common in childhood-onset IgAV. Recurrence
was noted in 35.6% of the population. Therefore, vigilant
monitoring for recurrence is necessary. |
| Key Words:
Immunoglobulin A vasculitis, Henoch-Schönlein
purpura, Nephritis, Recurrence, Relapse |
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