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ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Rheumatology
Volume 13 - 2025 | doi: 10.3389/fped.2025.1587535
Risk Factors for Gastrointestinal Bleeding in Children with Henoch-Schönlein Purpura
Provisionally accepted- Xiamen Children's Hospital/Children's Hospital of Fudan University Xiamen Branch, Xiamen, Xiamen, Fujian Province, China
To analyze the risk factors associated with gastrointestinal bleeding in pediatric patients with Henoch-Schönlein purpura (HSP), with the goal of enhancing early diagnosis and treatment, preventing complications, and improving patient outcomes.The study involved 23 pediatric patients with HSP who experienced gastrointestinal bleeding, forming the study group. They were admitted to our hospital from June 2023 to June 2024. For comparison, a control group composed of 44 children with HSP but without gastrointestinal bleeding, admitted during the same timeframe, was established. Data on clinical characteristics, laboratory results, and imaging findings were collected. Both univariate and multivariate analyses were conducted to identify potential risk factors. Results: A total of 67 children with HSP were divided into two groups: those with gastrointestinal bleeding (23 cases) and those without (44 cases). The occurrence of abdominal pain and incidence of intestinal wall thickening detected by gastrointestinal ultrasonography were significantly higher in the group with gastrointestinal bleeding compared to the group without bleeding (P ＜ 0.05). Univariate analysis revealed significant differences in eight laboratory parameters (WBC, NE, NLR, PCT, CRP, D-dimer, Fib, TT), all statistically significant (P<0.05). Multivariate analysis identified three independent risk factors for gastrointestinal bleeding in children with HSP: abdominal pain (OR=2.334, 95% CI: 0.458-11.886, P=0.010), a PCT level above 0.12 ng/mL (OR=10.010, 95% CI: 1.208-82.929, P=0.033), and a D-dimer level exceeding 1.87 mg/L (OR=3.407, 95% CI: 1.022 -17.473, P<0.001).The findings confirmed that abdominal pain, elevated PCT levels, and increased D-dimer are significant independent risk factors for gastrointestinal bleeding in pediatric patients with Henoch-Schönlein purpura. Clinicians should monitor these indicators attentively to enhance patient management and outcomes.
Keywords: Abdominal Pain, d-dimer, gastrointestinal bleeding, Henoch-Schönlein purpura, Procalcitonin, Risk factors
Received: 04 Mar 2025; Accepted: 04 Apr 2025.
Copyright: © 2025 Su, Yang, Wang, Li and Hong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
De-quan Su, Xiamen Children's Hospital/Children's Hospital of Fudan University Xiamen Branch, Xiamen, Xiamen, Fujian Province, China
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