Clinical Analysis Of Fecal Calvonin In Children With Abdominal IgA Vasculitis

Objective:1.The clinical manifestations and clinical data of 107 children with IgA angculitis(less than 18 years old)admitted to the Second Hospital of Hebei Medical University from July 2021 to January 2023 were collected and counted to improve the cognition of IgA vasculitis in children.2.By analyzing the differences in gender,age,weight,fecal calverin(FC),white blood cell(WBC)count,platelet(PLT)count,D-dimer,fibrin degradation product(FDP),hypersensitive C-reactive protein(CRP),joint involvement,renal involvement,IgA vasculitis score,hospitalization days,hormone dosage(mg / kg),intestinal ultrasound in children with IgA vasculitis(abdominal IgA angculitis)and IgA vasculitis without gastrointestinal symptoms,For the clinical diagnosis of children with abdominal IgA vasculitis,The stratification of the severity levels,Treatment efficacy and recurrence monitoring are help.Methods:1.From July 2021 to January 2023,pediatric nephrology and rheumatism immunology,and 107 children with IgA vasculitis met the diagnostic criteria of EULAR / PRINTO / PRES.2.Among the 107 children included,the initial onset was selected without any corticosteroids or cytotoxic drugs within 4 weeks before admission,and children with gastrointestinal surgery history,combined tumors,other autoimmune diseases,children with other inflammatory bowel diseases such as Crohn,ulcerative colitis,gastrointestinal symptoms may be caused by other factors,such as acute gastroenteritis,irritable bowel;and the data analysis of children using Excel software Social Sciences Statistics package26.0.3.Group: The clinical data of the included children were divided into gastrointestinal involvement and no gastrointestinal involvement groups according to the presence of gastrointestinal symptoms;FC> 50 ug / g and FC ug 50 ug / g.Then,the clinical data,experimental indicators and ultrasound examination results of each group were summarized and analyzed,and the statistical significance was expressed as P <0.05.4.The correlation between FC test changes,WBC count,D-dimer,CRP test changes,and hospitalization days,hormone dosage(mg/kg).Results:In the statistics of 107 children with IgA vasculitis:1.Mean age(8.30±3.438),26 males,20 females,mean age(8.48±2.964),34 males and 27 females.The difference of demographic data between the children affected and unaffected gastrointestinal groups was not significant(P> 0.05).2.The FC level was significantly higher than that in the GI involvement group,statistically significant(264.546±320.74 and 49.459±89.08ug/g,P<0.001).3.In the laboratory indicators,WBC in the gastrointestinal involvement group(10.943±4.267 and 8.122±3.911,P=0.001),CRP(17.746±18.460 and7.583±12.358,P=0.002),D-dimer(0.912±1.028 and 0.556±0.770,P=0.014),The hidden blood test(P<0.001)was higher than the group without gastrointestinal involvement,The difference was statistically significant,PLT(357.93±111.780 and 329.02±80.265,P=0.124)and FDP(5.590±7.069 and3.484 ±5.969,P=0.105)was not statistically significant in the two groups.4.The number of hospitalization was statistically significant in comparison(16.40±6.864 and 11.82±5.384,P <0.001);and the total amount of hormone therapy(mg/kg)in both groups(21.149±23.360 and 8.239±11.834,P<0.001).5.Comparing the gastrointestinal involvement group with the gastrointestinal involvement group,the difference in children with abnormal bowel ultrasound was statistically significant between the gastrointestinal involvement group and the gastrointestinal involvement group.6.Children in the FC level> 50 ug/g versus 50 ug/g and FC level> 50ug/g showed more frequent gastrointestinal involvement(75.6%,P <0.001),and in FC> 50 ug/g and FC 50 ug/g(P> 0.05).7.In the FC level> 50 ug/g group and FC level 50 ug/g group,FC level> 50 ug/g mean age(7.85±3.111),mean weight(31.923±14.922)kg,25 males,16 females;the mean age in FC level 50 ug/g group(8.74 ± 3.169years),mean weight(38.150±18.136)g,35 males,31 females.No comparison of demographic data between the FC level> 50 ug/g and 50 ug /g(P> 0.05).8.Laboratory examination indicators were compared in the FC level of>50 ug/g group and the FC level of 50 ug/g group,WBC(11.170±5.466 and8.260±2.9010,P=0.007),CRP(16.499 ± 16.752 and 9.040 ± 14.780,P=0.018),PLT(357.93±111.780 and 329.02 ± 80.265,P=0.124)and FDP(5.590 ± 7.069 and 3.484 ± 5.969,P=0.105)was not statistically significant in the two groups.D-dimer(0.954±1.029 and 0.538±0.750,P=0.001),the occult blood test(56.7%)was significantly higher in FC> 50 ug/g than 50 ug/g,statistically significant.9.The total number of bowel ultrasound abnormalities was significantly higher in the FC level> 50 ug/g(41.4%)than in the FC level of 50 ug/g(7.58%).10.Comparing the FC level> 50ug/g group with FC level 50 ug/g,hospitalization days and hormone dosage(mg/kg)at FC level> 50 ug/g(16.07± 7.431(21.531 ±24.810,P<0.001)and the FC level of 50 ug/g group(12.33± 5.237,P=0.001;8.979 ± 11.585,P<0.001).11.When the cutoff value for fecal calverin levels was 57.07ug/g,the diagnostic sensitivity and specificity were 65.4% and 86.4%,respectively.12.In children hospitalization after 1 week,review the children the indicators,analysis of FC and WBC before and after treatment,D-dimer detection value,CRP detection value change correlation analysis,analysis results,FC before and after the treatment and D after the correlation(P=0.005),the changes are positively correlated.Conclusions:1.Fecal calverin is diagnostic for abdominal IgA vasculitis.2.The level of fecal calvin can be used to assess the severity of gastrointestinal involvement in children,and the higher the detection value,the heavier the gastrointestinal inflammation.3.In the diagnosis of abdominal IgA vasculitis,fecal calveonin has the advantages of more convenience,earlier detection and higher sensitivity than intestinal tube ultrasound examination.4.Dynamic monitoring of fecal calretrin levels during the treatment of children with abdominal IgA vasculitis is useful for clinical condition monitoring.