Kidney involvement in adults with IgA vasculitis: experiences from Clinical Hospital Dubrava, Zagreb

Abstract

Introduction: IgA vasculitis, formerly named henoch-schönlein purpura, is a systemic small-vessel vasculitis that occurs commonly in children, while in adults, the disease remains rare. It is characterised by non-thrombocytopenic palpable purpura, arthritis, arthralgia, kidney disease and gastrointestinal pain. This study aimed to determine clinical signs and symptoms, laboratory and pathohistological parameters and therapy of IgA vasculitis in adults with renal involvement, by conducting our research on a sample of patients of a tertiary referral hospital. Research subjects and methods: In this retrospective cohort study, patients treated at clinical hospital dubrava from 2011 to 2019 were included, who were diagnosed with IgA vasculitis, based on clinical, laboratory and pathohistological criteria. clinical and laboratory parameters, were determined through the use of methods commonly used in clinical practice. In patients with symptoms and signs of kidney involvement and after patients’ consent, kidney biopsy was performed, and analysed by light, immunofluorescence and electron microscopy. Results: twenty-two adults (12 m, 10 F), whose median age was 57, were included in our study. Palpable purpura and nephritis were present in all patients. Thirteen (59.1%) patients had arthralgia and five of them (22.5%) experienced abdominal pain. respiratory infection preceded vasculitis in six (27.3%) patients, six patients ((27.3%) were taking medications and got vaccinated prior to the occurrence of vasculitis, and in ten (45.4%) patients the predisposing factor was unknown. Asymptomatic hematuria was present in ten (47.6%), subnephrotic proteinuria in three (14.3%), nephrotic syndrome in nine (42.9%) and nephritic syndrome in three (14.3%) patients. According to the findings of kidney biopsy, which was performed on 18 patients, eleven (61.6%) had mesangial proliferation, fourteen Reumatizam 2020;67(2):83–92 https://doi.org/10.33004/reumatizam-67-2-8 professional paper struČni rad