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Clinical features of patients with late onset IgA vasculitis differ from patients with early onset
Distinct clinical features, such as more renal involvement, were observed in patients with late onset immunoglobulin A vasculitis compared to patients with early onset vasculitis, according to recently published data.
Researchers reviewed data from 100 patients with immunoglobulin A (IgA) vasculitis diagnosed at one tertiary hospital in South Korea between January 1997 and December 2014. The mean patient age was 45.6 years, and 50% of the patients were women. All patients met EULAR/ Paediatric Rheumatology International Trials Organisation/Paediatric Rheumatology European Society criteria and were older than 20 years. The study included four patients with no purpuric skin lesions, but who had other IgA vasculitis clinical features.
Investigators recorded clinical characteristics, including known potential triggers, and history of upper respiratory tract infection, drug use, insect bites and vaccinations. Patients were assessed for proteinuria, hematuria and renal insufficiency. Investigators categorized patients younger than 60 years at disease onset in the early onset group and patients older than 60 years in the late onset group.
Sixty-one patients had early onset disease, and 75% of patients did not have a history of triggering factors; eight had a prior malignancy; and three were diagnosed with cancer and IgA vasculitis concomitantly. At the time of diagnosis, kidney involvement was present in 70% of patients.
Early and late onset groups were similar regarding gender distribution, but the early onset group was more likely to have a history of upper respiratory tract infection. The late onset group was more likely to have renal involvement, including hematuria and proteinuria but not nephrotic range proteinuria, which was more likely to continue through follow-up. Hypertension and diabetes were more common in late onset patients at presentation. The need for corticosteroids or immunosuppression drugs was similar between the groups. – by Shirley Pulawski
Disclosure: The researchers report no relevant financial disclosures.