Title :

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

Author(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]
Service de médecine interne, médecine vasculaire et dermatologie Nord
Centre Hospitalier Universitaire de La Réunion [CHU La Réunion]
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]
Hôpital Cochin [AP-HP]
Service de médecine interne et centre de référence des maladies rares [CHU Cochin]
Maillot, Francois [Auteur]
Centre Hospitalier Régional Universitaire de Tours [CHRU Tours]
Terrier, Benjamin [Auteur]
Université Paris Descartes - Faculté de Médecine [UPD5 Médecine]
Centre de référence des maladies auto-immunes systémiques rares d'Île-de-France / National Reference Center for Rare Systemic Autoimmune Diseases

Journal title :

Rheumatology

Abbreviated title :

Rheumatology (Oxford)

Publication date :

2020-03-24

ISSN :

1462-0332

Keyword(s) :

bleeding
IgA vasculitis
Henoch-Schonlein purpura
outcome
prognosis
gastrointestinal involvement

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [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 ...
Show more >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.Show less >

Language :

Anglais

Peer reviewed article :

Oui

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Inserm
Université de Lille

Collections :

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

Submission date :

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