Clinico-epidemiological profile and long-term follow-up of IgA vasculitis in children admitted in a tertiary care hospital in Eastern India

Background: IgA vasculitis is the most common systemic vasculitis seen in children.
Objectives: To assess the clinical and epidemiological profile of IgA vasculitis in children admitted in a tertiary care centre, the short-term outcome at 6 months and the long term follow up of this cohort for 2 years.
Method: A hospital based prospective, observational study was conducted at the Department of Paediatric Medicine of a tertiary care hospital in Eastern India. IgA vasculitis patients fulfilling European League against Rheumatism (EULAR) criteria were enrolled from February 2021 to August 2022 and were subsequently followed up for a period of 2 years.  
Results: A total of 33 children aged 1-12 years was enrolled; 3 were excluded due to alternate diagnosis. Male to female ratio was 1:1. The mean age was 7.6 ± 2.33 years; 40% of cases occurred in winter; 53.3% were from rural areas. Clinical features noted were purpuric rashes (100%), arthralgia (46.6%), arthritis (26.6%), renal manifestations (13.3%) and testicular swelling (3.3%). Among the four Henoch-Schonlein Purpura (HSP) nephritis cases, 2 had isolated microscopic haematuria, and 2 had nephritic syndrome. Renal biopsy was done in two (6.6%) and showed HSP nephritis Class 1. Seven (23.2%) patients received pulse methyl prednisolone, six for upper gastrointestinal bleeding and one for orchitis; 13.3% had hypertension and renal involvement during 6 month follow up; 16.6% showed recurrence of rash. Up to 6 recurrences were noted during the 2-year follow-up period; 11 patients could be followed up to 2 years.
Conclusions: Male to female ratio was 1:1. Mean age was 7.6 ± 2.33 years. Common clinical features were purpuric rashes (100%), arthralgia (46.6%), arthritis (26.6%) and renal manifestations (13.3%). Seven (23.2%) patients received pulse methyl prednisolone. Recurrence of rash occurred in 16.6%.