Immunological Features of Children with Gastrointestinal Bleeding Due to Henoch-Schönlein Purpura

Abstract

Background

This study aims to evaluate the immunological features of gastrointestinal (GI) bleeding in children with Henoch-Schönlein purpura (HSP).

Study Design

This retrospective study was conducted on children with HSP. Demographic and clinical data were collected, including serum immunoglobulin (Ig) levels, complement C3 and C4 levels, and lymphocyte subtype percentage.

Results

A total of 446 hospitalized children had HSP. Eighty-six children with HSP had GI bleeding, 114 had proteinuria, and 107 had hematuria. Lower arthralgia, prolonged glucocorticoid use, increased white blood cell counts, elevated neutrophils and neutrophil-to-lymphocyte ratio, reduced IgG and C3 levels, elevated CD19⁺ cell percentage, and reduced CD3⁺ cell and natural killer cell percentages were associated with GI bleeding risk in patients with HSP. Multivariate regression analysis revealed that arthralgia, glucocorticoid use, increased neutrophil percentage, reduced IgG and C3 levels, and increased CD19⁺ cell percentage were independent predictors of GI bleeding. Further analysis indicated that the combination of C3 and CD19⁺ cell percentages had a high predictive ability for GI bleeding in children with HSP.

Conclusion

This study indicated that reduced C3 and increased CD19⁺ cell percentages contributed to the development of GI bleeding in children with HSP. Specific immunologic profiles may be strongly correlated with GI bleeding risk in children with HSP.

Keywords:

• children
• complement
• gastrointestinal bleeding
• Henoch-Schönlein purpura
• lymphocyte subtype

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors declare that the research was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest.

Additional information

Funding

2022 In-hospital Science and Technology Innovation Fund of Sichuan Provincial Maternity and Child Health Care Hospital (CXPJ2022-01).