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
ARTICLE HIGHLIGHTS
Research background

The incidence rate of intussusception in Henoch-Schönlein purpura (HSP) is about 5%. It is the most common surgical acute abdomen in children with HSP. However, few reports have assessed the etiology of intussusception in children with HSP due to low clinical incidence. In particular, the risk factors for intussusception in children with HSP are largely unknown.

Research motivation

The aim of this study was to identify risk factors for the development of intussusception in children with HSP and gastrointestinal (GI) involvement.

Research objectives

The aim of this study was to identify risk factors for the development of intussusception in children with HSP and GI involvement.

Research methods

Sixty children with HSP and intussusception who were hospitalized at Beijing Children's Hospital Affiliated to Capital Medical University from January 2006 to December 2018 were selected. One hundred cases of abdominal HSP without intussusception at Beijing Children's Hospital during the same period were randomly selected as a control group. The general clinical data of all HSP patients were investigated, including gender, age of onset, onset time, clinical symptoms and signs, laboratory examination, imaging manifestations, treatment measures, etc. Univariate and multiple logistic regression analyses were performed to identify possible risk factors.

Research results

The 60 children in the intussusception group included 27 girls (45%) and 33 boys (55%), while 100 children in the non-intussusception group included 62 girls (62%) and 38 boys (38%). The median age was 6 years and 5 mo. Univariate and multivariate regression analyses showed that age of onset, failure to receive glucocorticoid treatment within 72 h after GI symptoms, hematochezia, and D-dimer levels were independent risk factors for intussusception in children with HSP (P < 0.05).

Research conclusions

Age at onset below 6 years, not receiving glucocorticoid therapy within 72 h of onset of GI symptoms, hematochezia, and increased D-dimer levels are independent risk factors for intussusception in children with HSP with GI involvement. Caution is needed in children suffering from HSP with GI involvement and showing at least one of the abovementioned factors, to avoid further disease aggravation and intussusception.

Research perspectives

In view of the above factors, it is necessary to conduct a large sample multicenter study.