Fecal calprotectin as a prognostic factor for gastrointestinal involvement in pediatric Henoch-Schölein purpura patients: a retrospective analysis

• Published in: BMC Pediatrics
• Main Authors: Eun Young Paek, Dae Yong Yi, Kang, Ben, Byung-Ho Choe
• Format: Web Resource
• Language: English
• Published: Durham Research Square 09.04.2020
• Subjects: Pediatrics; Purpura
• DOI: 10.21203/rs.3.rs-21357/v1

Background Henochchönlein purpura (HSP) is a systemic vasculitis occurring in children. HSP prognosis is usually good, but its recurrence is relatively common, and if the intestines get affected, severe complications could arise, including intussusception or intestinal perforation. Here, we investigated the value of fecal calprotectin (FC) in early screening of HSP and the usefulness of FC as a prognostic factor for GI manifestations. Methods We retrospectively reviewed the medical records of pediatric patients who were diagnosed with HSP and had undergone FC testing during the acute phase. Subjects were categorized into gastrointestinal (GI) involvement and non-GI involvement groups based on their clinical symptoms. Moreover, GI involvement levels were divided as follows: upper GI tract up to the duodenum and lower GI tract from the ileocolic Results Sixty-nine patients were diagnosed with HSP and underwent FC testing. Among them, 40 patients (58.0%) showed signs of GI involvement. The GI involvement group showed higher FC levels (379.9 짹 399.8 vs. 77.4 짹 97.6 mg/kg, P = 0.000). There were no significant differences in the relapse of HSP symptoms or GI symptoms. The cut-off value according to GI involvement was 69.10 mg/kg (P < 0.01). Patients with FC levels of >50 mg/kg more frequently showed GI involvement (77.8% vs. 20.8%, P = 0.000) and a more severe prognosis. Significant correlations were observed for abdominal pain duration, HSP clinical score, and abdominal pain severity (P = 0.002, P = 0.000, and P = 0.000, respectively). Additionally, FC levels were significantly higher in patients with lower GI tract involvement (214.67 짹 150.5 vs. 581.8 짹 510.1 mg/kg, P = 0.008), and the cut-off value was 277.5 mg/kg (P < 0.01). Conclusion FC testing is useful for predicting the involvement of GI, location of involvement, and course of prognosis in pediatric HSP patients.