Palabras clave
Vasculitis leucocitoclástica
Complejos inmunes por IgA
Erupción cutánea
Biomarcadores
Corticosteroides
Inmunosupresores
Nefritis
Cómo citar
Resumen
La vasculitis por IgA es la vasculitis más frecuente en la infancia se caracteriza por una vasculitis leucocitoclástica en la que están afectados los capilares por depósito de complejos inmunes de IgA. La erupción cutánea es la principal manifestación clínica junto con artralgias o artritis, afección del tracto digestivo y renal, a menudo tiene un curso auto limitado. Aunque se presenta a cualquier edad tiene una predilección por niños entre 3 y 7 años. Es común que se identifique un desencadenante, el más frecuentemente asociado es infeccioso, con reportes de hasta el 31% con infecciones de vías respiratorias, seguida de gastrointestinales en un 5%. Las manifestaciones dermatológicas son el elemento característico de la enfermedad y se encuentra en el 100% de los pacientes, sin embargo, la afectación renal es la que determina el pronóstico. El diagnóstico es clínico apoyado en auxiliares de laboratorio, gabinete y los criterios de clasificación; sin embargo, debido a que el pronóstico está condicionado principalmente por la afectación renal, tener alternativas simples y seguras, el adecuado seguimiento, la evaluación de la eficacia del tratamiento y el pronóstico de la enfermedad, son algunos de los principales objetivos de los biomarcadores. El tratamiento inicial se basa en medidas generales, pero en caso de afección gastrointestinal, renal u otro órgano blanco como testículos, el tratamiento con corticosteroides e inmunosupresores es necesario. Desde finales del siglo pasado se reconoció que no todos los pacientes con vasculitis por IgA tenían un desenlace benigno, sin embargo, recientemente se ha publicado información que sustenta un desenlace deletéreo tanto en los pacientes con nefritis como en el embarazo.
Palabras clave: Vasculitis por IgA; Vasculitis leucocitoclástica; Complejos inmune por IgA; Erupción cutánea; Biomarcadores; Corticosteroides; Inmunosupresores; Nefritis.
Referencias
1. Masarweh K, Horovitz Y, Avital A, Spiegel R. Establishing hospital admission criteria of pediatric Henoch-Schönlein purpura. Rheumatol Int 2014; 34: 1497-1503. doi: 10.1007/s00296-014-2971-9.
2. Nutan Kamath, Suchetha Rao. Henoch-Schönlein purpura: An update. Indian J Rheumatol 2012; 7: 92-98. doi: 10.1016/S0973-3698(12)60034-X.
3. Lei WT, Tsai PL, Chu SH, et al. Incidence and risk factors for recurrent Henoch-Schönlein purpura in children from a 16-year nationwide database. Pediatr Rheumatol Online J 2018; 16:25. doi: 10.1186/s12969-018-0247-8.
4. Ding Y, Zhou Y, Li HR, Xiong YH, et al. Characteristics of immune function in the acute phase of Henoch-Schönlein purpura. Clin Rheumatol 2021; 40: 3711-3716. doi: 10.1007/s10067-021-05707-6.
5. Pohl M. Henoch-Schönlein purpura nephritis. Pediatr Nephrol 2015; 30: 245-252. doi: 10.1007/s00467-014-2815-6.
6. Cantillo-Turbay JJ, Iglesias-Gamarra A. Historia de la púrpura de Henoch-Schönlein. Acta Med Colomb 2007; 32: 97-100.
7. Chen JY, Mao JH. Henoch-Schönlein purpura nephritis in children: incidence, pathogenesis and management. World J Pediatr 2015; 1: 29-34. doi: 10.1007/s12519-014-0534-5.
8. Xu L, Li Y, Wu X. IgA vasculitis update: Epidemiology, pathogenesis, and biomarkers. Front Immunol 2022; 13: 921864. doi: 10.3389/fimmu.2022.921864.
9. Piram M, Mahr A. Epidemiology of immunoglobulin A vasculitis (Henoch-Schönlein): current state of knowledge. Curr Opin Rheumatol 2013; 25: 171-178. doi: 10.1097/BOR.0b013e32835d8e2a.
10. González LM, Janniger CK, Schwartz RA. Pediatric Henoch-Schönlein purpura. Int. J. Dermatol 2009; 48: 1157-65.
11. Trapani S, Michell A, Grisolia F, Resti M, et al. Henoch Schönlein purpura in childhood: epidemiological and clinical analysis of 150 cases over a 5-year period and review of literature. Semin Arthritis Rheum 2005; 35: 143-153.
12. Murata C, Rodríguez-Lozano AL, Hernández-Huirache HG, et al. IgA vasculitis (Henoch - Schönlein Purpura) as the first manifestation of juvenile Systemic Lupus Erythematosus: Case-control study and systematic review. BMC Pediatrics 2019; 19: 461. doi: 10.1186/s12887-019-1829-4.
13. Saulsbury FT. Clinical update: Henoch-Schönlein purpura. Lancet 2007; 369: 976-978.
14. Rigante D, Castellazzi L, Bosco A, Esposito S. Is there a crossroad between infections, genetics, and Henoch-Schönlein purpura? Autoimmun Rev 2013; 12:1016-21.
15. Batu ED, Sener S, Ozen S. COVID-19 associated pediatric vasculitis: A systematic review and detailed analysis of the pathogenesis. Semin Arthritis Rheum 2022; 55: 152047. doi: 10.1016/j.semarthrit.2022.152047.
16. Messova A, Pivina L, Muzdubayeva Z, Sanbayev D, et al. COVID-19 and New Onset IgA Vasculitis: A Systematic Review of Case Reports. J Emerg Nurs 2022; 48: 348-365. doi: 10.1016/j.jen.2022.05.002.
17. Park SJ, Suh JS, Lee JH, et al. Advances in our understanding of the pathogenesis of Henoch-Schönlein purpura and the implications for improving its diagnosis. Expert Rev Clin Immunol 2013; 9: 1223-1238. doi: 10.1586/1744666X.2013.850028.
18. Hastings MC, Rizk DV, Kiryluk K, Nelson R, et al. IgA vasculitis with nephritis: update of pathogenesis with clinical implications. Pediatr Nephrol 2022; 37: 719-33. doi: 10.1007/s00467-021-04950-y.
19. Li B, Ren Q, Ling J, Tao Z, et al. The change of Th17/Treg cells and IL-10/IL-17 in Chinese children with Henoch-Schönlein purpura: A PRISMA-compliant meta-analysis. Medicine (Baltimore) 2019; 98: e13991. doi: 10.1097/MD.0000000000013991.
20. Saulsbury FT. Alterations in the O-linked glycosylation of IgA1 in children with Henoch-Schönlein purpura. J Rheumatol 1997; 24: 2246-2249.
21. Allen AC, Willis FR, Beattie TJ, Feehally J. Abnormal IgA glycosylation in Henoch-Schönlein purpura restricted to patients with clinical nephritis. Nephrol Dial Transplant 1998; 13: 930-934. doi: 10.1093/ndt/13.4.930.
22.Yang YH, Tsai IJ, Chang CJ, Chuang YH, et al. The interaction between circulating complement proteins and cutaneous microvascular endothelial cells in the development of childhood Henoch-Schönlein purpura. PLoS One 2015; 10: e0120411.
23. Yang YH, Yu HH, Chiang BL. The diagnosis and classification of Henoch-Schönlein purpura: an update review. Autoimmun Rev 2014; 13: 355-8.
24. Maguiness S, Balma-Mena A, Pope E, Weinstein M. Bullous Henoch-Schönlein purpura in children: a report of 6 cases and review of the literature. Clin Pediatr 2010; 49: 1033-7.
25. Trnka P. Henoch-Schönlein purpura in children. J Paediatr Child Health 2013; 49: 995-1003.
26. Marro J, Williams C, Pain CE, Oni L. A case series on recurrent and persisting IgA vasculitis (Henoch Schönlein purpura) in children. Pediatr Rheumatol Online J 2023; 21: 85.
27. Kamei K, Ogura M, Sato M, Ito S, et al. Evolution of IgA nephropathy into anaphylactoid purpura in six cases-Further evidence that IgA nephropathy and Henoch-Schönlein purpura nephritis share common pathogenesis. Pediatr Neprol 2016; 31: 779-85.
28. Mao S, Xuan Xiaoyan, Sha Y, Zhao S, et al. Clinico-pathological association of Henoch-Schoenlein purpura nephritis and IgA nephropathy in children. Int J Clin Exp Pathol 2015; 8: 2334-42.
29. Alhasan K, Aloudah NM, Bakhit AA, et al. Renal histopathology spectrum in children with kidney diseases in Saudi Arabia, 1998-2017. Saudi Med J 2020; 41: 369-375. doi: 10.15537/smj.2020.4.24999.
30. Tu J, Chen C, Cao L, Chen D, et al. Analysis of clinical manifestations and pathological findings in children with massive proteinuria with Henoch Schönlein purpura nephritis. Zhonghua Er Ke Za Zhi 2015; 53: 379-82.
31. Liu LJ, Yu J, Li YN. Clinical characteristics of Henoch-Schönlein purpura in children. Zhongguo Dan Dai Er Ke Za Zhi 2015; 17: 1079-83.
32. Paydary K, Emamzadeh Fard S, Mahboubi AH, Ziaee V, et al. Penile Skin Involvement as the First Presentation of Henoch-Schönlein Purpura Report of Nine Cases and Review of Literature. Iran J Pediatr 2015; 25: e2177. doi: 10.5812/ijp.2177.
33. Reamy BV, Servey JT, Williams PM. Henoch-Schönlein Purpura (IgA Vasculitis): Rapid Evidence Review. Am Fam Physician 2020; 102: 229-33.
34. Stefek B, Beck M, Loffreda M, Gardner L, et al. Henoch-Schönlein Purpura with Posterior Reversible Encephalopathy Syndrome. J Pediatr 2015; 167: 1152-4.
35. Zhang S, Wang Q, Li Z, Guo Q. Testicular ischemia associated with IgA vasculitis in a child: a case report and literature review. Front Pediatr 2023; 11: 1219878.
36. Garzoni L, Vanoni F, Rizzi M, et al. Nervous system dysfunction in Henoch-Schönlein syndrome: systematic review of the literature. Rheumatology (Oxford) 2009; 48: 1524-1529.
37. Di Pietro GM, Castellazzi ML, Mastrangelo A, Montini G, et al. Henoch-Schönlein Purpura in children: not only kidney but also lung. Pediatr Rheumatol Online J 2019; 17: 75. doi: 10.1186/s12969-019-0381-y.
38. Kang Z, Wu W, Xun M, Ding Y, et al. Henoch-Schönlein Purpura /IgA Vasculitis Complicated by Coronary Artery Aneurysm: A Case Report and Literature Review. Front Pediatr 2022; 9: 781106.
39. Yılmaz N, Yüksel S, Becerir T, Gi̇ri̇şgen İ, et al. Myocarditis and intracardiac thrombus due to Henoch-Schönlein purpura: case report and literature review. Clin Rheumatol 2020; 40: 1635-44.
40. Kaur S, Maheshwari A, Aneja S, et al. Henoch–Schönlein purpura with uveitis: an unusual case and review of literature. Rheumatol Int 2012; 32: 4057-59.
41. Shivpuri A, Turtsevich I, Solebo AL, Compeyrot-Lacassagne S. Pediatric uveitis: Role of the pediatrician. Front Pediatr 2022; 10: 874711.
42. Ozen S, et al. EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis 2010; 69: 798-806.
43. Li B, Ren Q, Ling J, Tao Z, et al. Clinical relevance of neutrophil-to-lymphocyte ratio and mean platelet volume in pediatric Henoch-Schönlein Purpura: a meta-analysis. Bioengineered 2021; 12: 286-295. doi: 10.1080/21655979.2020.1865607.
44. Zhu L, Zhang C, Xiang R, Luo Y. Correlations of Leukotriene B4 and 25-Hydroxyvitamin D3 Levels with Disease Severity in Children with Henoch-Schönlein Purpura. Clin Lab 2022; 68: 211030. doi: 10.7754/Clin.Lab.2021.211030.
45. Rigante D, Guerriero C, Silvaroli S, et al. Predictors of Gastrointestinal Involvement in Children with IgA Vasculitis: Results from a Single-Center Cohort Observational Study. Children (Basel). 2024; 11: 215. doi: 10.3390/children11020215.
46. Ozen S, Marks SD, Brogan P, et al. European consensus-based recommendations for diagnosis and treatment of immunoglobulin A vasculitis-the SHARE initiative. Rheumatology (Oxford). 2019; 58: 1607-1616. doi: 10.1093/rheumatology/kez041.
47. Ekinci RMK, Balci S, Sari Gokay S, et al. Do practical laboratory indices predict the outcomes of children with Henoch-Schönlein purpura? Postgrad Med 2019; 131: 295-298. doi: 10.1080/00325481.2019.1609814.
48. Chen O, Zhu XB, Ren H, Wang YB, et al. The imbalance of Th17/Treg in Chinese children with Henoch-Schönlein purpura. Int Immunopharmacol 2013; 16: 67-71. doi: 10.1016/j.intimp.2013.03.027.
49. Parums DV. A Review of IgA Vasculitis (Henoch-Schönlein Purpura) Past, Present, and Future. Med Sci Monit 2024; 30: e943912. doi:10.12659/MSM.943912.
50. Williams CEC, Lamond M, Marro J, Chetwynd AJ, Oni L. A narrative review of potential drug treatments for nephritis in children with IgA vasculitis (HSP). Clin Rheumatol 2023; 42: 3189-3200. doi: 10.1007/s10067-023-06781-8.
51. Tan J, Tang Y, Zhong Z, et al. The efficacy and safety of immunosuppressive agents plus steroids compared with steroids alone in the treatment of Henoch-Schönlein purpura nephritis: A meta-analysis. Int Urol Nephrol 2019; 51: 975-985. doi: 10.1007/s11255-019-02092-7.
52. Hahn D, Hodson EM, Craig JC. Interventions for preventing and treating kidney disease in IgA vasculitis. Cochrane Database Syst Rev 2023; 2: CD005128. doi: 10.1002/14651858.CD005128.pub4.
53. Delbet JD, Parmentier C, Herbez Rea C, et al. Management of IgA Vasculitis with Nephritis. Paediatr Drugs 2021; 23: 425-435. doi: 10.1007/s40272-021-00464-0.
54. Fu Q, Shi MF, Chen Y. Clinical effect of alfacalcidol in children with Henoch-Schönlein purpura: a prospective randomized controlled trial. Zhongguo Dang Dai Er Ke Za Zhi 2021; 23: 797-801. doi: 10.7499/j.issn.1008-8830.2105136.
55. Hoeger PH. Prognostic parameters in Henoch-Schönlein purpura. Br J Dermatol 2015; 172: 1191-1192. doi: 10.1111/bjd.13723.
56. de Almeida JL, Campos LM, Paim LB, Leone C, et al. Renal involvement in Henoch-Schönlein purpura: a multivariate analysis of initial prognostic factors. J Pediatr (Rio J) 2007; 83: 259-266. doi: 10.2223/JPED.1638.
57. Davin JC. Henoch-Schönlein purpura nephritis: pathophysiology, treatment, and future strategy. Clin J Am Soc Nephrol 2011; 6: 679-689. doi: 10.2215/CJN.06710810.
58. Carmona Cruz S, García Romero M. Manifestaciones clínicas y paraclínicas iniciales en pacientes con púrpura de Henoch Schönlein y persistencia de actividad renal. [tesis especialidad en pediatría]. Ciudad de México: Universidad Nacional Autónoma de México, 2019; pp: 70.
59. Caltik A, Demircin G, Bülbül M, Erdogan O, et al. An unusual case of ANA negative systemic lupus erythematosus presented with vasculitis, long-standing serositis and full-house nephropathy. Rheumatol Int 2013; 33: 219-222. doi: 10.1007/s00296-010-1540-0.
60. Al-Attrach I, Al-Shibli A, Al-Riyami L, Al-Salam S. Systemic lupus erythematosus with severe nephritis that mimicked Henoch-Schoenlein purpura. Arab J Nephrol Transplant 2011; 4: 159-161. doi: 10.4314/ajnt.v4i3.71029.
61. Abdwani R, Abdalla E, El-Naggari M, Al Riyami M. Henoch-Schönlein purpura with lupus-like nephritis: an uncommon occurrence. Int J Rheum Dis 2017; 20: 1853-1855. doi: 10.1111/1756-185X.12461.
62. Hu P, Huang BY, Zhang DD, Jiang GM, et al. Henoch-Schönlein purpura in a pediatric patient with lupus. Arch Med Sci 2017; 13: 689-90.
63. Zubair A. Frieri M. Lupus Nephritis: review of the literature. Curr Allergy Asthma Rep 2013; 13: 580-586.
64. Sinha R. Raut S. Pediatric lupus nephritis: Management update. World J Nephrol 2014; 6:16-23.
65. Corthesy B. Multi-faceted functions of secretory IgA at mucosal surfaces. Front Immunol 2013; 4: 185.
66. Ding L, Chen X, Cheng H, Zhang T, et al. Advances in IgA glycosylation and its correlation with diseases. Front Chem 2022; 10: 974854. doi: 10.3389/fchem.2022.974854.
67. Leong KW, Ding JL. The unexplored roles of human serum IgA. DNA Cell Biol 2014; 33: 823-829. doi: 10.1089/dna.2014.2639.
68. Kotzin BL. Susceptibility loci for lupus: a guiding light from murine models? J Clin Invest 1997; 99: 557-558.
69. Mathsson L, Ahlin E, Sjowall C, Skogh T, et al. Cytokine induction by circulating immune complexes and signs of in-vivo complement activation in systemic lupus erythematosus are associated with the occurrence of anti-Sjogren’s syndrome antibodies. Clin Exp Immunol 2007; 147: 513-520.
70. Truedsson L, Bengtsson AA, Sturfelt G. Complement deficiencies and systemic lupus erythematosus. Autoimmunity 2007; 40: 560-566.
71. Panda S, Zhang J, Tan NS, Ho B, et al. Natural IgG antibodies provide innate protection against ficolin-opsonized bacteria. EMBO J 2013; 32: 2905-2919.
72. Cunningham-Rundles C. Physiology of IgA and IgA deficiency. J Clin Immunol 2001; 21: 303-309.
73. Wang N, Shen N, Vyse TJ, Anand V, Gunnarson I, et al. Selective IgA deficiency in autoimmune diseases. Mol Med (Cambridge, Mass) 2011; 17: 1383-1396.
74. Wyatt RJ, Julian BA. IgA nephropathy. N Engl J Med 2013; 368: 2402–2414.
75. Suzuki H, Novak J. IgA glycosylation and immune complex formation in IgAN. Semin Immunopathol 2021; 43: 669-678. doi: 10.1007/s00281-021-00883-8.
76. Han S, Collins BE, Bengtson P, Paulson JC. Homomultimeric complexes of CD22 in B cells revealed by protein-glycan cross-linking. Nat Chem Biol 2005; 1: 93-97.
77. Goulabchand R, Batteux F, Guilpain P. Glycosylation des autoanticorps au cours des maladies auto-immunes [Glycosylation of autoantibodies in autoimmunes diseases]. Rev Med Interne 2013; 34: 746-753. doi: 10.1016/j.revmed.2013.09.005.
78. Parekh R, Dwek R, Sutton B, et al. Association of rheumatoid arthritis and primary osteoarthritis with changes in the glycosylation pattern of total serum IgG. Nature 1985; 316: 452–457. doi: 10.1038/316452a0.
79. Moresco RN, Speeckaert MM, ZmonarskiSC, et al. Urinary myeloid IgA Fc alpha receptor (CD89) and transglutaminase-2 as new biomarkers for active IgA nephropathy and Henoch-Schönlein purpura nephritis. BBA Clinical 2016; 5: 79-84.
80. Pillebout E, Jamin A, Ayari H, et al. Biomarkers of IgA vasculitis nephritis in children. PLoS One 2017; 12: e0188718. doi: 10.1371/journal.pone.0188718.
81. An JK, Xia D. Diagnostic performance of urinary proteins as biomarkers in evaluating Henoch Schönlein purpura nephritis. Int J Clin Exp Med 2018; 11: 12354-12360.
82. Del Vecchio GC, Penza R, Altomare M, et al. Cytokine pattern and endothelium damage markers in Henoch-Schönlein purpura. Immunopharmacol Immunotoxicol 2008; 30: 623-629. doi: 10.1080/08923970801973646.
83. Ye Q, Shang SQ, Liu AM, et al. 24h Urinary Protein Levels and Urine Protein/Creatinine Ratios Could Probably Forecast the Pathological Classification of HSPN. PLoS One 2015; 10: e0127767. doi: 10.1371/journal.pone.0127767.
84. Ge W, Wang HL, Sun RP. Pentraxin 3 as a novel early biomarker for the prediction of Henoch-Schönlein purpura nephritis in children. Eur J Pediatr 2014; 173: 213-218. doi: 10.1007/s00431-013-2150-0.
85. Fuentes Y, Hernández AM, García-Roca P, et al. Urinary MCP-1/creatinine in Henoch-Schönlein purpura and its relationship with nephritis. Pediatr Nephrol 2014; 29: 1047-1052. doi: 10.1007/s00467-013-2740-0.
86. Wang J, Ying Q, Zhong S, et al. Elevated urinary monocyte chemoattractant protein-1 levels in children with Henoch-Schönlein purpura nephritis. Pediatr Neonatol 2018; 59: 238-243. doi: 10.1016/j.pedneo.2017.08.008.
87. Chen X, Hou Y, Chen C, Jiang G. The predictive value of β2-microglobulin for steroid resistance in children with Henoch-Schönlein purpura nephritis. Int J Dermatol 2020; 59: e363-e364. doi: 10.1111/ijd.15052.
88. Pillebout E, Sunderkötter C. IgA vasculitis. Semin Immunopathol 2021; 43: 729-738. doi.org/10.1007/s00281-021-00874-9.
89. Li Q, Shi S, Liu L, Lv J, et al. Neutrophil-to-lymphocyte ratio as an independent inflammatory indicator for poor renal prognosis in adult IgA vasculitis with nephritis. Int Immunopharmacol 2022; 111: 109178. doi: 10.1016/j.intimp.2022.109178.
90. Makay B, Gücenmez ÖA, Duman M, Ünsal E. The relationship of neutrophil-to-lymphocyte ratio with gastrointestinal bleeding in Henoch-Schönlein purpura. Rheumatol Int 2014; 34: 1323-1327. doi: 10.1007/s00296-014-2986-2.
91. Nagy GR, Kemény L, Bata-Csörgő Z. Neutrophil-to-lymphocyte ratio: a biomarker for predicting systemic involvement in adult IgA vasculitis patients. J Eur Acad Dermatol Venereol 2017; 31: 1033-1037. doi: 10.1111/jdv.14176.
92. Brogan P, Eleftheriou D. Vasculitis update: pathogenesis and biomarkers. Pediatr Nephrol 2018; 33: 187-198. doi: 10.1007/s00467-017-3597-4.
93. Jaszczura M, Góra A, Grzywna-Rozenek E, Barć-Czarnecka M, et al. Analysis of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and mean platelet volume to platelet count ratio in children with acute stage of immunoglobulin A vasculitis and assessment of their suitability for predicting the course of the disease. Rheumatol Int 2019; 39: 869-878. doi: 10.1007/s00296-019-04274-z.
94. d'Angelo DM, Franchini S, Mohn A, Breda L. Factor XIII as a potential predictor of severe gastrointestinal involvement in Henoch Schoenlein purpura: A case study research. J Paediatr Child Health 2020; 56: 1821-1823. doi: 10.1111/jpc.14886.
95. Marro J, Chetwynd AJ, Edwards S, Wright RD, et al. Increased Urinary IgA in Paediatric IgA Vasculitis Nephritis. Int J Mol Sci 2022; 23: 14548. doi: 10.3390/ijms232314548.
96. Sugino H, Sawada Y, Nakamura M. IgA Vasculitis: Etiology, Treatment, Biomarkers and Epigenetic Changes. Int J Mol Sci 2021; 22: 7538. doi: 10.3390/ijms22147538.
97. Held M, Kozmar A, Sestan M, et al. Insight into the Interplay of Gd-IgA1, HMGB1, RAGE and PCDH1 in IgA Vasculitis (IgAV). Int J Mol Sci 2024; 25: 4383. doi: 10.3390/ijms25084383.
98. Dyga K, Machura E, Świętochowska E, Szczepańska M. Analysis of the association between kidney injury biomarkers concentration and nephritis in immunoglobulin A vasculitis: A pediatric cohort study. Int J Rheum Dis 2020; 23: 1184-1193. doi: 10.1111/1756-185X.13904.
99. Williams CEC, Toner A, Wright RD, Oni L. A systematic review of urine biomarkers in children with IgA vasculitis nephritis. Pediatr Nephrol. 2021; 36: 3033-3044. doi: 10.1007/s00467-021-05107-7.
100. Zhu ZQ, Zhang T, Chang S, Ren ZH, et al. AZGP1 as a potential biomarker of IgA vasculitis with nephritis in a children based urinary proteomics study by diaPASEF. Mol Med Rep 2023; 28: 157. doi: 10.3892/mmr.2023.13044.
101. Marro J, Chetwynd AJ, Wright RD, Dliso S, Oni L. Urinary Protein Array Analysis to Identify Key Inflammatory Markers in Children with IgA Vasculitis Nephritis. Children (Basel). 2022; 9: 622. doi: 10.3390/children9050622.
102. Frkovic M, Turcic A, Gagro A, et al. Erythrocyte Glutathione S-Transferase Activity as a Sensitive Marker of Kidney Function Impairment in Children with IgA Vasculitis. Int J Mol Sci 2024; 25: 3795. doi: 10.3390/ijms25073795.
103. Deki S, Hamada R, Mikami N, et al. Half of children with IgA vasculitis-associated nephritis with nephrotic state spontaneously recover. Nephrology (Carlton) 2022; 27: 681-689. doi: 10.1111/nep.14041.
104. Liao CH, Tsai M, Yang YH, Chiang BL, et al. Onset age is a risk factor for refractory pediatric IgA vasculitis: a retrospective cohort study. Pediatr Rheumatol Online J 2020; 18: 86. doi: 10.1186/s12969-020-00480-3.
105. Sestan M, Kifer N, Sozeri B, et al. Clinical features, treatment and outcome of pediatric patients with severe cutaneous manifestations in IgA vasculitis: Multicenter international study. Semin Arthritis Rheum 2023; 61: 152209. doi: 10.1016/j.semarthrit.2023.152209.
106. Li Y, Zhang X, Liu H, et al. Severe gastrointestinal involvement in pediatric IgA vasculitis: a retrospective single-center cohort study in China. Front Pediatr 2023; 11: 1194214. doi: 10.3389/fped.2023.1194214.
107. Jelusic M, Sestan M, Cimaz R, Ozen S. Different histological classifications for Henoch-Schönlein purpura nephritis: which one should be used? Pediatr Rheumatol Online J 2019; 17: 10. doi: 10.1186/s12969-019-0311-z.
108. Goldstein AR, White RH, Akuse R, Chantler C. Long-term follow-up of childhood Henoch-Schönlein nephritis. Lancet 1992; 339: 280-282. doi: 10.1016/0140-6736(92)91341-5.
109. Nossent J, Raymond W, Keen H, Inderjeeth C, Preen D. Pregnancy outcomes in women with a history of immunoglobulin A vasculitis. Rheumatology (Oxford) 2019; 58: 884-888. doi: 10.1093/rheumatology/key408.
110. Besse MC, Perrotin F, Aouba A, et al. Pregnancy outcome in patients with a medical history of immunoglobulin A vasculitis: a case-control study. Scand J Rheumatol 2024; 53: 36-43. doi: 10.1080/03009742.2023.2226518.
111. Beça S, Alba MA, Hernández-Rodríguez J, et al. Maternal and fetal outcomes of pregnancy in women with primary systemic vasculitis: A single-center cohort study of 20 patients and 30 pregnancies. Semin Arthritis Rheum 2024; 66: 152412. doi: 10.1016/j.semarthrit.2024.152412.
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
Derechos de autor 2025 Revista Alergia México