Kožna očitovanja u IgA vaskulitisu

master's thesis

• Title (english): Cutaneous manifestations in IgA vasculitis
• Author: Ante Vidović
• Mentor: Marija Jelušić (mentor)
• Committee member: Nevena Krnić (predsjednik povjerenstva)
• Committee member: Romana Čeović (član povjerenstva)
• Committee member: Marija Jelušić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pediatrics); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics

Abstract

IgA vaskulitis (IgAV) najčešći je sustavni vaskulitis dječje dobi. PogaĎa male krvne ţile i u većini slučajeva očituje se blagom vrućicom i koţnim promjenama. Koţna očitovanja uglavnom su u obliku purpuričnog osipa po donjim udovima i glutealno, a rjeĎe se javljaju generalizirani osip ili teţe koţne promjene poput nekroze i ulceracija. Cilj je ovog rada prikazati koţna očitovanja IgA vaskulitisa te ispitati njihov utjecaj na kliničke i laboratorijske značajke bolesti. Kroz ovo istraţivanje, retrospektivno smo analizirali podatke bolesnika s IgAV-om koji su liječeni u Referentnom centru za pedijatrijsku i adolescentnu reumatologiju Ministarstva zdravstva Republike Hrvatske, u razdoblju od siječnja 2009. do rujna 2021. godine. Od ukupno 226 bolesnika, 124 (54,8%) imala su tipičan raspored osipa po donjim udovima i glutealno, a ostali su imali atipičan osip pri čemu se kod 93 (41,2%) koţni osip proširio iznad donjih udova, a 9 (4%) bolesnika imalo je teške koţne promjene u obliku ulceracija, nekroza i/ili bula. Medijan dobi u trenutku dijagnoze iznosio je 6,5 godina te je više bilo bolesnih dječaka (123) nego djevojčica (103). Skupina bolesnika s atipičnim koţnim osipom imala je statistički značajno dulje trajanje hospitalizacije, zahvaćanje gastrointestinalnog sustava i bubrega te su češće liječeni sustavnim glukokortikoidima i antihipertenzivima. Uz to, imali su statistički značajno manju razinu trombocita i IgG, kao i kraće protrombinsko vrijeme. Ovi rezultati naglašavaju činjenicu da su koţna očitovanja IgAV-a povezana s teţinom kliničke slike bolesti u cjelini.

Abstract (english)

IgA vasculitis (IgAV) is the most common systemic vasculitis in childhood. It affects small blood vessels and presents itself in most cases with mild fever and skin lesions. Cutaneous manifestations are usually in a form of purpuric rash localized on lower extremities and gluteal region, whereas generalized rash or severe skin lesions, such as necrosis or ulcerations, are not so common. The goal of this research is to give an overview of cutaneous manifestations of IgA vasculitis and examine its impact on clinical and laboratory features. We have made a retrospective analysis of data from patients with IgAV treated at the Centre of Reference for Pediatric and Adolescent Rheumatology of the Ministry of Health of the Republic of Croatia, in the period from January 2009 to September 2021. Total number of patients was 226; 124 (54.8) of them had typical rash distribution on lower extremities and gluteal region. Others had atypical rash and among them 93 (41.2%) had generalized rash, whilst 9 (4%) had severe skin lesions such as ulcerations, necrosis and/or bullae. The age median was 6.5 years and boys (123) outnumbered girls (103). The patients with atypical skin rash had statistically significant more gastrointestinal involvement, higher incidence of IgA nephritis and they were more frequently treated with glucocorticoids and antihypertensives. Furthermore, they had statistically significant lower thrombocyte count and IgG, as well as shorter prothrombin time. These findings suggest that cutaneous manifestations of IgAV have an impact on the severity of clinical presentation of IgA vasculitis.

• Keywords: IgA vaskulitis; kožna očitovanja; djeca
• Keywords (english): IgA vasculitis; cutaneous manifestations; children
• Language: croatian
• URN:NBN: urn:nbn:hr:105:705842
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-03-20 09:59:54