Atopic Dermatitis and Association of Risk for Henoch–Schönlein Purpura (IgA Vasculitis) and Renal Involvement Among Children

Wei, Chang; Lin, Cheng Li; Shen, Te Chun; Li, Tsai‐Chung; Chen, An Chyi

doi:10.1097/md.0000000000002586

Cited by 16 publications

(11 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous limited reports have suggested that children with atopic eczema may have an increased risk of nephrotic syndrome. 20 , 21 , 22 , 23 Use of cyclosporine for severe atopic eczema could lead to an increased risk of chronic kidney disease, although similar estimates were seen in our study when adjusting, albeit fairly crudely, for use of systemic treatment for atopic eczema. Increased risks of chronic kidney disease have also been observed in other inflammatory dermatoses such as psoriasis.…”

Section: Discussionsupporting

confidence: 79%

Atopic eczema in adulthood and mortality: UK population–based cohort study, 1998-2016

Silverwood

Mansfield

Mulick

et al. 2021

Journal of Allergy and Clinical Immunology

View full text Add to dashboard Cite

Background: Atopic eczema affects up to 10% of adults and is becoming more common globally. Few studies have assessed whether atopic eczema increases the risk of death. Objective: We aimed to determine whether adults with atopic eczema were at increased risk of death overall and by specific causes and to assess whether the risk varied by atopic eczema severity and activity. Methods: The study was a population-based matched cohort study using UK primary care electronic health care records from the Clinical Practice Research Datalink with linked hospitalization data from Hospital Episode Statistics and mortality data from the Office for National Statistics from 1998 to 2016. Results: A total of 526,736 patients with atopic eczema were matched to 2,567,872 individuals without atopic eczema. The median age at entry was 41.8 years, and the median follow-up time was 4.5 years. There was limited evidence of increased hazard for all-cause mortality in those with atopic eczema (hazard ratio 5 1.04; 99% CI 5 1.03-1.06), but there were somewhat stronger associations (8%-14% increased hazard) for deaths due to infectious, digestive, and genitourinary causes. Differences on the absolute scale were modest owing to low overall mortality rates. Mortality risk increased markedly with eczema severity and activity. For example, patients with severe atopic eczema had a 62% increased hazard (hazard ratio 5 1.62; 99% CI 5 1.54-1.71) for mortality compared with those without eczema, with the strongest associations for infectious, respiratory, and genitourinary causes. Conclusion: The increased hazards for all-cause and causespecific mortality were largely restricted to those with the most severe or predominantly active atopic eczema. Understanding the reasons for these increased hazards for mortality is an urgent priority. (J Allergy Clin Immunol 2020;nnn:nnn-nnn.)

show abstract

Section: Discussionsupporting

confidence: 79%

Atopic eczema in adulthood and mortality: UK population–based cohort study, 1998-2016

Silverwood

Mansfield

Mulick

et al. 2021

Journal of Allergy and Clinical Immunology

View full text Add to dashboard Cite

show abstract

“…Our finding that allergic rhinitis was an independent risk factor for HSP was in line with studies reporting an increased risk of HSP in atopic children [ 29 , 30 ]. However, no study has addressed the correlation between recurrent HSP and allergic diseases.…”

Section: Discussionsupporting

confidence: 92%

Incidence and risk factors for recurrent Henoch-Schönlein purpura in children from a 16-year nationwide database

et al. 2018

View full text Add to dashboard Cite

BackgroundThe recurrence rate of Henoch-Schönlein purpura (HSP) is 2.7%–30%, with varied average intervals between the first and second episodes. Few studies have explored the incidence and risk factors for recurrent HSP.MethodsWe used a 16-year nationwide database to analyze the incidence of recurrent HSP. Patients with HSP were identified, and risk factors for recurrent HSP were explored. Kaplan-Meier and Cox regression model analyses were performed, and covariates were adjusted in the multivariate model.ResultsFrom January 1, 1997 to December 31, 2012, among 2,886,836 individuals in the National Health Insurance Research Database, 1002 HSP patients aged < 18 years were identified. Among them, 164 had ≥2 HSP episodes (recurrence rate, 16.4%; incidence of recurrent HSP, 7.05 per 100 person-years); 83.6% patients with one HSP episode remained free of secondary HSP. The average time intervals between the first and second and second and third HSP episodes were 9.2 and 6.4 months, respectively. After adjusting for demographic parameters, comorbidities, and socioeconomic status, recurrent HSP was found to occur more frequently in patients who had renal involvement (adjusted hazard ratio, 2.41; 95% confidence interval [CI], 1.64–3.54; p < 0.001), were receiving steroid therapy for > 10 days (adjusted hazard ratio, 8.13; 95%CI, 2.51–26.36; p < 0.001), and had allergic rhinitis (adjusted hazard ratio, 1.63; 95%CI, 1.06–2.50; p = 0.026).ConclusionsThe annual incidence of recurrent HSP was low. However, children who had underlying allergic rhinitis, presented with renal involvement, and received steroid treatment for > 10 days should be notified regarding the possibility of recurrence.Electronic supplementary materialThe online version of this article (10.1186/s12969-018-0247-8) contains supplementary material, which is available to authorized users.

show abstract

“…However, recent meta-analyses have failed to identify associations between AD and type 1 diabetes or MS [ 69 , 70 ]. Other possible autoimmune comorbidities include autoimmune thyroid disease [ 59 , 60 , 71 ] and autoimmune nephropathy [ 60 , 72 – 74 ], although the number of studies are limited and results are inconsistent.…”

Section: Introductionmentioning

confidence: 99%

Comorbidities of Atopic Dermatitis: Beyond Rhinitis and Asthma

et al. 2017

View full text Add to dashboard Cite

Purpose of ReviewIn this review article, we summarize the current evidence about atopic dermatitis (AD)-associated comorbidities, beyond the traditional atopic and allergic conditions.Recent FindingsPatients with AD may have an increased risk of cardiovascular diseases, certain malignancies, autoimmune diseases, and neuropsychiatric diseases. The causes of these associations are likely multifactorial and may include genetic predispositions, systemic low-grade inflammation, environmental exposures, medication, and lifestyle and behavioral risk factors. There appears to be geographical variations in prevalence of comorbidities in patients with AD, indicating that differences in ethnicity and lifestyle factors may significantly influence the risk of certain comorbidities.SummaryThe reported comorbidities in recent literature emphasize the burden of disease in patients with AD. Early appropriate AD therapy, in combination with reduction of risk factors, may help prevention of certain comorbidities. The reported observations may generate hypotheses for future investigations in underlying risk factors for AD-associated comorbidities.

show abstract

Atopic Dermatitis and Association of Risk for Henoch–Schönlein Purpura (IgA Vasculitis) and Renal Involvement Among Children

Cited by 16 publications

References 31 publications

Atopic eczema in adulthood and mortality: UK population–based cohort study, 1998-2016

Atopic eczema in adulthood and mortality: UK population–based cohort study, 1998-2016

Incidence and risk factors for recurrent Henoch-Schönlein purpura in children from a 16-year nationwide database

Comorbidities of Atopic Dermatitis: Beyond Rhinitis and Asthma

Contact Info

Product

Resources

About