SEVERE gastrointestinal involvement in paediatric IgA vasculitis is associated with renal involvement in children, according to a retrospective single centre cohort study examining clinical characteristics, gastrointestinal manifestations and renal outcomes between August 2023 and June 2024.

Paediatric IgA Vasculitis and Renal Involvement

IgA vasculitis is characterised by IgA dominant immune deposits and is the most common vasculitis in children, with gastrointestinal symptoms such as abdominal pain and gastrointestinal bleeding frequently occurring early. Renal involvement is an important complication that may be associated with persistent urinary abnormalities or nephritis, making early identification important for monitoring.

This study aimed to characterise gastrointestinal manifestations in children with IgA vasculitis and assess their association with renal involvement, including timing during follow up.

The study included 68 children with IgA vasculitis and 44 of these had available follow up data. Gastrointestinal manifestations were observed in 82.4% of patients, with 55.4% of those cases classified as severe. Renal involvement, defined as haematuria or proteinuria, was present in 19 of 44 patients (43.2%) by the end of follow up. This included 14 cases identified at baseline and five cases that developed during follow up.

Gastrointestinal Severity and Renal Outcomes

Severe gastrointestinal involvement was associated with renal involvement in multivariable analysis (odds ratio: 4.34; 95% CI: 1.48–12.65; p=0.007). This association remained directionally consistent in sensitivity and subgroup analyses, although statistical significance was not maintained across all analyses.

These findings suggest a relationship between gastrointestinal severity and renal involvement in paediatric IgA vasculitis, supporting further evaluation of gastrointestinal features in risk assessment.

Clinical Implications and Follow Up Considerations

The observed association between severe gastrointestinal involvement and renal manifestations in paediatric IgA vasculitis may have implications for clinical monitoring. Children presenting with more severe gastrointestinal symptoms may benefit from closer renal surveillance during follow-up to enable early detection of renal abnormalities such as haematuria or proteinuria.

However, the authors note that the single centre design and limited sample size restrict generalisability. Further multicentre studies with longer follow-up are needed to confirm these findings and better define risk patterns in paediatric IgA vasculitis with renal manifestations.

Reference

Mai TT, Le TH. Severe gastrointestinal involvement is associated with renal manifestations in pediatric IgA vasculitis: a retrospective cohort study. BMC Pediatr. 2026;DOI:10.1186/s12887-026-07051-7.

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