Venous sinus thrombosis in a case of immunoglobulin A vasculitis and a systemic review of literature

Zheng, Qi; Qian, He; Huang, Hongxia; Lu, Meiping

doi:10.1111/1756-185x.14529

Cited by 3 publications

(3 citation statements)

References 20 publications

(45 reference statements)

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“…It was hypothesized that thrombocytosis promotes thrombosis during the course of IgAV and may contribute to testicular infarction. In addition, deep vein thrombosis and venous sinus thrombosis secondary to IgAV have been reported ( 33 , 34 ). Although the significance of IgM levels in patients with IgAV remains unclear, the results of this study suggest that IgM levels are closely associated with testicular/epididymal involvement.…”

Section: Discussionmentioning

confidence: 99%

Immunoglobulin a vasculitis with testicular/epididymal involvement in children: A retrospective study of a ten-year period

Zhao

Wen

et al. 2023

Front. Pediatr.

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The clinical characteristics and risk factors for testicular/epididymal involvement in 73 children with immunoglobulin A vasculitis (IgAV) who were admitted to our hospital between January 2012 and November 2022 were reviewed. The demographic data, laboratory parameters, and follow-up data of the patients were compared to those of 146 males without testicular/epididymal involvement. A logistic regression analysis was performed to determine the variables associated with testicular/epididymal involvement. The prevalence of testicular/epididymal involvement among male patients with IgAV was 1.3% (73/5,556). Increased blood flow in the testes and/or epididymis on ultrasound was found in 71 patients. The remaining two patients underwent surgical exploration for loss or reduction of testicular blood flow. One patient underwent orchiectomy for intraoperative confirmation of complete right testicular infarction. Pathological findings revealed IgA immune complex deposition in the testis. Patient age (odds ratio [OR] = 0.792; 95% confidence interval [CI]: 0.682–0.919, p = 0.002), platelet count (OR = 1.011; 95% CI: 1.002–1.020, p = 0.013), and immunoglobulin M (IgM) levels (OR = 0.236; 95% CI: 0.091–0.608, p = 0.003) were strongly associated with the occurrence of testicular/epididymal involvement in IgAV. Therefore, young age, increased platelet count, and low IgM levels in patients with IgAV are potential risk factors for testicular/epididymal involvement. Doppler ultrasound can help differentiate IgAV from acute scrotum. Most patients with testicular/epididymal involvement have good prognoses, although serious complications such as testicular infarction may occur.

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Section: Discussionmentioning

confidence: 99%

Immunoglobulin a vasculitis with testicular/epididymal involvement in children: A retrospective study of a ten-year period

Zhao

Wen

et al. 2023

Front. Pediatr.

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“…Cerebral venous thrombosis is associated with the development of systemic lupus erythematosus [13], LgA-associated vasculitis [14], and Behcet's disease [15], but rarely GCA-related [16]. The occurrence of CVST is even more infrequent, accounting for less than 1% of all cases, with an estimated one-year incidence rate of 3-4 cases per one million people.…”

Section: Discussionmentioning

confidence: 99%

Giant cell arteritis combined with venous sinus thrombosis: A case report and systematic review

Li,

Zhang,

Wang

2023

Preprint

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Background Giant cell arteritis (GCA) is a low-incidence systemic vasculitis in Asian populations. It is considered a rare cause of cerebral venous sinus thrombosis (CVST). This case report presents a rare case of an Asian patient with GCA accompanied by CVST. Case Presentation: A 67-year-old man who had been experiencing varicose veins in the bilateral temporal region for four years and complete loss of vision in the right eye for four months sought medical attention in our emergency department due to loss of vision in the left eye for two weeks and fever for three days. On admission, this patient had a recurrent fever, and no source of infection was identified. Conventional anti-infective treatment was ineffective. Based on the clinical presentation, a diagnosis of GCA combined with CVST was made, and hormone therapy was administered. The patient was discharged with normal body temperature, clear consciousness, recovery of vision in both eyes, and improved clinical parameters. Conclusions This case report presents a distinct manifestation of both GCA and CVST. The coexistence of GCA and CVST is not solely attributed to increased blood viscosity, inflammation of the vascular wall, and abnormal coagulation. It also involves a complex immunological network. This case report may help clinicians make comprehensive clinical decisions in similar cases.

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“…Henoch-Schönlein purpura (HSP), also known as IgA vasculitis, is an immune-responsive systemic small vessel vasculitis that affects the skin, gastrointestinal tract, joints, and kidneys. 1,2 Known as abdominal Henoch-Schönlein purpura (AHSP), when gastrointestinal (GI) symptoms prevail, it can present with persistent abdominal pain in less severe cases or paroxysmal severe abdominal pain and gastrointestinal bleeding in severe cases which can be life-threatening.…”

Section: Introductionmentioning

confidence: 99%

Artificial intelligence differentiates abdominal Henoch‐Schönlein purpura from acute appendicitis in children

Nie,

Zhan,

et al. 2023

Int J of Rheum Dis

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ObjectiveThis study aims to construct an artificial intelligence (AI) model capable of effectively discriminating between abdominal Henoch‐Schönlein purpura (AHSP) and acute appendicitis (AA) in pediatric patients.MethodsA total of 6965 participants, comprising 2201 individuals with AHSP and 4764 patients with AA, were enrolled in the study. Additionally, 53 laboratory indicators were taken into consideration. Five distinct artificial intelligence (AI) models were developed employing machine learning algorithms, namely XGBoost, AdaBoost, Gaussian Naïve Bayes (GNB), MLPClassifier (MLP), and support vector machine (SVM). The performance of these prediction models was assessed through receiver operating characteristic (ROC) curve analysis, calibration curve assessment, and decision curve analysis (DCA).ResultsWe identified 32 discriminative indicators (p < .05) between AHSP and AA. Five indicators, namely the lymphocyte ratio (LYMPH ratio), eosinophil ratio (EO ratio), eosinophil count (EO count), neutrophil ratio (NEUT ratio), and C‐reactive protein (CRP), exhibited strong performance in distinguishing AHSP from AA (AUC ≥ 0.80). Among the various prediction models, the XGBoost model displayed superior performance evidenced by the highest AUC (XGBoost = 0.895, other models < 0.89), accuracy (XGBoost = 0.824, other models < 0.81), and Kappa value (XGBoost = 0.621, other models < 0.60) in the validation set. After optimization, the XGBoost model demonstrated remarkable diagnostic performance for AHSP and AA (AUC > 0.95). Both the calibration curve and decision curve analysis suggested the promising clinical utility and net benefits of the XGBoost model.ConclusionThe AI‐based machine learning model exhibits high prediction accuracy and can differentiate AHSP and AA from a data‐driven perspective.

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Venous sinus thrombosis in a case of immunoglobulin A vasculitis and a systemic review of literature

Cited by 3 publications

References 20 publications

Immunoglobulin a vasculitis with testicular/epididymal involvement in children: A retrospective study of a ten-year period

Immunoglobulin a vasculitis with testicular/epididymal involvement in children: A retrospective study of a ten-year period

Giant cell arteritis combined with venous sinus thrombosis: A case report and systematic review

Artificial intelligence differentiates abdominal Henoch‐Schönlein purpura from acute appendicitis in children

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