Titre :

Gastrointestinal involvement in adult iga vasculitis (henoch-schönlein purpura): updated picture from a french multicentre and retrospective series of 260 cases

Auteur(s) :

Audemard-Verger, Alexandra [Auteur]
Centre Hospitalier Régional Universitaire de Tours [CHRU Tours]
Pillebout, Evangeline [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Amoura, Zahir [Auteur]
Cacoub, Patrice [Auteur]
Immunologie - Immunopathologie - Immunothérapie [CHU Pitié Salpêtrière] [I3]
Jourde-Chiche, Noémie [Auteur]
CHU Marseille
Lioger, Bertrand [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Martis, Nihal [Auteur]
Centre Hospitalier Universitaire de Nice [CHU Nice]
Moulis, Guillaume [Auteur]
Centre Hospitalier Universitaire de Toulouse [CHU Toulouse]
Riviere, Etienne [Auteur]
Service de médecine interne et maladies infectieuses [Bordeaux]
Baldolli, Aurelie [Auteur]
Unité de Maladies Infectieuses et Tropicales [CHU Caen]
Girard, Charlotte [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Goutte, Julie [Auteur]
Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] [CHU ST-E]
Le Gouellec, Noémie [Auteur]
Centre hospitalier [Valenciennes, Nord]
Raffray, Loic [Auteur]
Centre Hospitalier Universitaire de La Réunion [CHU La Réunion]
Service de médecine interne, médecine vasculaire et dermatologie Nord
Urbanski, Geoffrey [Auteur]
Centre Hospitalier Universitaire d'Angers [CHU Angers]
Sanges, Sébastien [Auteur]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Maurier, Francois [Auteur]
Hôpital-Clinique Claude-Bernard [Metz]
Thervet, Eric [Auteur]
Hôpital Européen Georges Pompidou [APHP] [HEGP]
Aouba, Achille [Auteur]
CHU Caen
Guillevin, Loic [Auteur]
Service de médecine interne et centre de référence des maladies rares [CHU Cochin]
Hôpital Cochin [AP-HP]
Maillot, Francois [Auteur]
Centre Hospitalier Régional Universitaire de Tours [CHRU Tours]
Terrier, Benjamin [Auteur]
Centre de référence des maladies auto-immunes systémiques rares d'Île-de-France / National Reference Center for Rare Systemic Autoimmune Diseases
Université Paris Descartes - Faculté de Médecine [UPD5 Médecine]

Titre de la revue :

Rheumatology

Nom court de la revue :

Rheumatology (Oxford)

Date de publication :

2020-03-24

ISSN :

1462-0332

Mot(s)-clé(s) :

bleeding
IgA vasculitis
Henoch-Schonlein purpura
outcome
prognosis
gastrointestinal involvement

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

OBJECTIVE: To describe the clinical presentation, treatments and prognosis of gastrointestinal (GI) involvement in adult IgA vasculitis (IgAV). METHODS: Data from 260 adults with IgAV included in a French multicentre ...
Lire la suite >OBJECTIVE: To describe the clinical presentation, treatments and prognosis of gastrointestinal (GI) involvement in adult IgA vasculitis (IgAV). METHODS: Data from 260 adults with IgAV included in a French multicentre retrospective survey were analysed. Presentation and outcomes of patients with (GI+) and without (GI-) GI involvement were compared. RESULTS: One hundred and thirty-seven (53%) patients had GI involvement. Initial manifestations were abdominal pain in 99%, intestinal bleeding in 31%, diarrhoea in 26% and acute surgical abdomen in only 4%. Abdominal imaging revealed thickening of intestinal wall in 61%, and endoscopies revealed abnormalities in 87%, mostly mucosal ulcerations. GI+ vs GI- patients were younger (46 ± 18 vs 54 ± 18 years; P = 0.0004), had more constitutional symptoms (43% vs 23%; P = 0.0005) and joint involvement (72 vs 50%; P = 0.0002), and higher CRP levels (3.7 vs 1.9 mg/dl; P = 0.001). Clinical response and relapse rates were comparable between groups, and all causes mortality (2 vs 4%) and IgAV-related mortality (1% vs 2%) as well. GI-related deaths were due to intestinal perforation and mesenteric ischaemia. CONCLUSIONS: GI involvement is frequent in adult IgAV. GI involvement is frequent in adult IgAV. Mortality is not uncommon but does not seem to be specifically related to GI. Immunosuppressants should not be preferred as first-line therapy for GI+ patients but may be required in case of acute surgical abdomen.Lire moins >

Langue :

Anglais

Comité de lecture :

Oui

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

CHU Lille
Inserm
Université de Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Date de dépôt :

2021-07-06T12:48:34Z
2024-03-29T11:11:24Z