Work

Coagulation and fibrinolysis biomarkers associated with gastrointestinal bleeding in children with immunoglobulin A vasculitis: a retrospective cohort study

Year: 2026

Type: article

Abstract: Objective This study aimed to explore alterations of soluble thrombomodulin (sTM), thrombin-antithrombin complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC), tissue plasminogen activator-inhibitor complex (t-PAIC), and D-dimer in children with immunoglobulin A vasculitis (IgAV). We further evaluated the associations of these hemostatic biomarkers and clinical features with gastrointestinal (GI) bleeding in this cohort of patients. Methods A retrospective cohort study was conducted at our hospital between September 2021 and April 2025, enrolling 126 consecutive children diagnosed with IgAV. Among these, 44 children presented with GI bleeding and 20 developed overt GI bleeding. Univariate and multivariate logistic regression analyses were performed to identify associated factors for GI bleeding in IgAV children. Moreover, the threshold values were assessed by receiver operating characteristic (ROC) curve analysis. Results There were no significant differences in age, gender, sTM and t-PAIC between GI bleeding and no-GI-bleeding groups in children with IgAV. Among IgAV children, those with GI bleeding had significantly higher neutrophils, neutrophil-to-lymphocyte ratio (NLR), fibrinogen (FIB), TAT, PIC and D-dimer levels than those without GI bleeding, along with decreased serum immunoglobulin G (IgG). Children with overt bleeding had prolonged hospital stay, higher dose of methylprednisolone administration and elevated serum IgM than those with occult bleeding. Multivariate regression analysis revealed that PIC (odds ratio [OR] = 1.888, 95% confidence intervals [CI] 1.013–3.518, P = 0.045; area under the curve [AUC] = 0.687) was independently associated with higher odds of GI bleeding with IgAV in childhood, and serum IgG (OR = 0.843, 95%CI: 0.737–0.965, P = 0.013). The AUC of combined model was 0.737. Conclusion Increased PIC levels and decreased serum IgG are closely correlated with GI bleeding in children with IgAV.

Source: Frontiers in Pediatrics

DOI: 10.3389/fped.2026.1886693

Authors: Fang Chen, Hanjun Shen, Xuejun Shao, Jia Wei

Institution: Soochow University

Language: English

Topic: Vasculitis and related conditions

Subfield: Rheumatology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801