What are the racial predilections for Henoch-Schönlein purpura (IgA vasculitis)?

Updated: Jan 08, 2021
  • Author: Rajendra Bhimma, MBChB, MD, PhD, DCH (SA), FCP(Paeds)(SA), MMed(Natal); Chief Editor: Craig B Langman, MD  more...
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Whites are affected more often than Blacks.

In a study from Thailand, patients most commonly presented between the ages of 3 and 5 years. [62] Frequency peaked from December to February. Organs involved included the skin (100%), GI tract (74.5%), and kidneys (46.8%). Joints were also affected (42.6%). Kidney involvement was detected within the first 2 months in 16 patients (72.7%); however, it was delayed until 6 months after diagnosis in 6 patients.

No risk factors for kidney involvement could be identified in this study. [62] Mean follow-up time was 2.6 years (range, 1-5 years). Residual kidney disease occurred in 6 (38%) of 16 patients, but none had end-stage kidney disease (ESKD).

In a study from China, a male predominance was observed in children but not in adults. [63] Preceding infection was noted in 40.5% of children and 31.6% of adults; 8.3% of children and 13.2% of adults were receiving medication at the onset of the disease. Abdominal pain was more common in children than adults (70.2% vs 28.9%), but kidney involvement was more common and severe in adults than in children; this involvement manifested as frequent hypertension and heavy proteinuria. [63] During acute attacks, leukocytosis, thrombocytosis, and elevated serum C-reactive protein (CRP) levels were most frequently observed in children, whereas elevated serum IgA and cryoglobulin levels were most common in adults.

A study of 450 cases from Turkey showed that girls, patients with atypical presentations, and patients undergoing early corticosteroid treatment had an increased risk of developing kidney disease; relapses occurred more often in children treated with corticosteroids. [64]

Familial kindreds with IgAV have been noted in Taiwanese aboriginal people. [65]

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