Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 6, 2021; 9(22): 6244-6253
Published online Aug 6, 2021. doi: 10.12998/wjcc.v9.i22.6244
Risk factors for intussusception in children with Henoch-Schönlein purpura: A case-control study
Qian Zhao, Yan Yang, Song-Wei He, Xin-Tai Wang, Chang Liu
Qian Zhao, Yan Yang, Song-Wei He, Xin-Tai Wang, Chang Liu, Traditional Chinese Medicine Department, National Children's Medical Center, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing 100045, China
Author contributions: All authors contributed to study conception and design; Zhao Q, Yang Y, He SW, Wang XT, and Liu C performed material preparation and data collection and analysis; Zhao Q wrote the first draft of the manuscript; all authors have revised the manuscript, and read and approved its final version.
Supported by the Beijing Traditional Chinese Medicine Science and Technology Development Fund, No. JJ2018-45; and the Beijing Municipal Natural Science Foundation, No. 7172076 and No. 7212169.
Institutional review board statement: This study conformed to the Helsinki Declaration on Human Beings and was approved by the Beijing Children's Hospital Affiliated to Capital Medical University (No. IEC-C-008-A08-V.05.1).
Informed consent statement: Informed consent was waived.
Conflict-of-interest statement: All authors have nothing to disclose.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yan Yang, MD, Doctor, Traditional Chinese Medicine Department, National Children’s Medical Center, Beijing Children’s Hospital affiliated to Capital Medical University, No. 56 Nanlishi Road, Xicheng District, Beijing 100045, China. yy2303@sina.com
Received: January 12, 2021
Peer-review started: January 12, 2021
First decision: April 29, 2021
Revised: May 7, 2021
Accepted: June 3, 2021
Article in press: June 3, 2021
Published online: August 6, 2021
Processing time: 196 Days and 14.9 Hours
Abstract
BACKGROUND

The etiology of Henoch-Schönlein purpura (HSP) with intussusception remains undefined.

AIM

To investigate the risk factors for intussusception in children with HSP and gastrointestinal (GI) involvement.

METHODS

Sixty children with HSP and concomitant intussusception admitted to the Beijing Children’s Hospital of Capital Medical University between January 2006 and December 2018 were enrolled in this study. One hundred pediatric patients with HSP and GI involvement but without intussusception, admitted to the same hospital during the same period, were randomly selected as a control group. The baseline clinical characteristics of all patients, including sex, age of onset, duration of disease, clinical manifestations, laboratory test results, and treatments provided, were assessed. Univariate and multiple logistic regression analyses were performed to identify possible risk factors.

RESULTS

The 60 children in the intussusception group comprised 27 girls (45%) and 33 boys (55%) and the 100 children in the non-intussusception group comprised 62 girls (62%) and 38 boys (38%). The median age of all patients were 6 years and 5 mo. Univariate and multiple regression analyses revealed age at onset, not receiving glucocorticoid therapy within 72 h of emergence of GI symptoms, hematochezia, and D-dimer levels as independent risk factors for intussusception in children with HSP (P < 0.05).

CONCLUSION

The four independent risk factors for intussusception in pediatric HSP with GI involvement would be a reference for early prevention and treatment of this potentially fatal disease.

Keywords: Henoch-Schönlein purpura; Intussusception; Gastrointestinal; Risk factors; Children; Logistic regression analysis

Core Tip: Intussusception has an incidence of about 5% in Henoch-Schönlein purpura (HSP), and is a common cause of acute surgical abdomen in the affected children. There is limited research on risk factors for intussusception in children with HSP. Age at onset below 6 years, not receiving glucocorticoid therapy within 72 h of onset of gastrointestinal (GI) symptoms, hematochezia, and increased D-dimer levels are independent risk factors for intussusception in children with HSP and GI involvement.