| Abstract | Ciljevi: Svrha ovog istraživanja bila je ispitati klinička obilježja IgA vaskulitisa kod pacijenata liječenih u Klinici za unutarnje bolesti KBC-a Split u petnaestogodišnjem razdoblju.
Ispitanici i postupci: Istraživanje je obuhvatilo 36 bolesnika s dijagnosticiranim IgA vaskulitisom u razdoblju od 2007. do 2022. godine. Prikupljeni podaci dobiveni su iz stacionara i dnevne bolnice Zavoda za reumatologiju i imunologiju Klinike za unutarnje bolesti KBC-a Split. Podatci su tijekom prikupljanja unošeni u Microsoft Excel program dok je u statističkoj obradi korišten program MedCalc. Od testova su pritom korišteni χ2 test, Mann-Whitney test, Pearsonova korelacija i logistička regresija.
Rezultati: Istraživanje je obuhvatilo 36 bolesnika s dijagnozom IgA vaskulitisa tijekom petnaestogodišnjeg razdoblja od kojih je bilo 29 muškaraca (80,6%) i 7 žena (19,4%). Medijan životne dobi iznosio je 62 godine (min-maks: 20-86 godina, Q1-Q3: 48-72 godine). Pokazala se statistički značajna razlika u razinama IgA u serumu između pacijenata starijih i mlađih od 60 godina kao i statistički značajna korelacija slabije snage između dobi i razina IgA u serumu. Od kliničkih očitovanja, najučestaliji simptom je bila purpura, zatim artritis i/ili artralgija, potom zahvaćenost bubrega te najrjeđe zahvaćenost gastrointestinalnog sustava. U konačnici se nije pokazala značajna razlika u kliničkom očitovanju kod pacijenata starijih i mlađih od 60 godina. U terapiji IgA vaskulitisa koristila se prvenstveno glukokortikoidna i imunosupresivna linija lijekova koja je u većini slučajeva dovela do poboljšanja stanja. Pritom se nije pokazala statistički značajna razlika u terapijskom izboru između definiranih dobnih skupina. Kod 10 pacijenata se određeni lijekovi mogu promatrati kao potencijalni okidači IgA vaskulitisa. Na kraju se pokazala statistički značajna razlika u broju pacijenata s poboljšanjem stanja kod uspoređivanih dobnih skupina.
Zaključci: Istraživanje je pokazalo 2,4 dijagnosticirana IgA vaskulitisa godišnje i omjer muškaraca i žena od 4:1. Također, utvrđena je statistički značajna razlika u razinama IgA u serumu između mlađih i starijih pacijenata te značajna korelacija slabije snage između dobi i razine IgA u serumu. Utvrđeno je kako ne postoji značajna razlika u simptomatologiji između mlađih i starijih pacijenata, a da je pritom učestalost promatranih simptoma jednaka u oba spola. Simptomi od češćih prema rjeđima su purpura, artritis i/ili atralgija; zahvaćenost bubrega i gastrointestinalnog sustava. Najčešće primjenjivani lijekovi su kortikosteroidi i imunosupresivi koji su u većini slučajeva doveli do poboljšanja stanja, a penicilini i cefalosporini mogu biti okidači pojave IgA vaskulitisa. |
| Abstract (english) | Objectives: The purpose of this study was to examine the clinical features of IgA vasculitis in patients treated in the Clinic for internal diseases at University Hospital of Split over a fifteen-year period.
Subjects and methods: The research included 36 patients diagnosed with IgA vasculitis in the period 2007-2022. The collected data were obtained from Department of rheumatology and immunology in the Clinic for internal diseases at University Hospital of Split. Data were entered into the Microsoft Excel program during the collection, while the MedCalc program was used for statistical processing. Among the tests, the χ2 test, Mann-Whitney test, Pearson's correlation and logistic regression were used.
Results: The research included 36 patients diagnosed with IgA vasculitis over a fifteen-year period, of whom there were 29 men (80.6%) and 7 women (19.4%). The median age was 62 years (min-max: 20-86 years, Q1-Q3: 48-72 years). A statistically significant difference in serum IgA levels between patients older and younger than 60 years was shown, as well as a statistically significant correlation of weaker strength between age and serum IgA levels. Of the clinical manifestations, the most common symptom was purpura, followed by arthritis and/or arthralgia, then kidney involvement, and the least frequent, involvement of the gastrointestinal system. In the end, no significant difference in clinical manifestations was shown in patients older than and younger than 60 years. In the therapy of IgA vasculitis, primarily glucocorticoid and immunosuppressive drugs were used, which in most cases led to improvement of the condition. There was no statistically significant difference in the choice of therapy between defined age groups. In 10 patients, certain drugs can be seen as potential triggers of IgA vasculitis. In the end, a statistically significant difference was shown in the number of patients with improved conditions in the compared age groups.
Conclusions: The research showed 2.4 diagnosed IgA vasculitis per year and a male to female ratio of 4:1. Also, a statistically significant difference in serum IgA levels was found between younger and older patients, as well as a significant weaker correlation between age and serum IgA levels. It was found that there is no significant difference in symptomatology between younger and older patients, while the frequency of observed symptoms is the same in both sexes. Symptoms from more common to less common are purpura, arthritis and/or arthralgia; involvement of the kidneys and gastrointestinal system. The most used drugs are corticosteroids and immunosuppressants, which in most cases lead to an improvement in the condition, while penicillin and cephalosporins can be triggers for the appearance of IgA vasculitis. |
