Full Papers
Clinical features and gastrointestinal bleeding risk factors in IgA vasculitis patients: a retrospective study in a large volume centre
J. Zhao1, X. Wang2, R. Xie3, Q. Juhou4, D. Wang5, X. Shi6, W. Zhang7, L. Shi8, Y. Peng9, X. Tang10
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China.
- Department of Gastroenterology, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Xuzhou, China.
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China.
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China.
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China.
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China.
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China.
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China.
- Department of Critical Care Medicine, Third Xiangya Hospital, Central South University, Changsha, China.
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China. solitude5834@hotmail.com
CER19241
Full Papers
Received: 25/08/2025
Accepted : 19/12/2025
In Press: 01/06/2026
Abstract
OBJECTIVES:
Gastrointestinal (GI) bleeding is a serious complication of immunoglobulin A vasculitis (IgAV), but reliable predictors are still lacking. This study aimed to identify clinical risk factors and develop a prediction model for IgAV-related GI bleeding in a large patient cohort.
METHODS:
In this retrospective study, 968 patients with IgAV from the Affiliated Hospital of Southwest Medical University (2019-2024) were divided into GI bleeding (n=484) and non-bleeding (n=484) groups. We analysed seasonal onset patterns and used multivariate logistic regression with ROC curve validation to identify predictors.
RESULTS:
This retrospective study revealed that summer-onset disease was associated with a significantly higher risk of GI bleeding compared to other seasons (OR=1.67, 95% CI:1.15–2.45; p=0.007), representing a 13.8% absolute risk increase (p<0.001). The neutrophil-to-albumin ratio (NAR) was the strongest biochemical predictor (OR=1.79; 95% CI:1.33–2.47; AUC=0.723). High systemic immune-inflammation index levels also increased risk (OR=2.91, 95% CI:1.67–5.08), while mean platelet volume (MPV) was protective (OR=0.78, 95% CI:0.68–0.90). A combined model including seasonality, NAR, and MPV showed superior predictive performance (AUC=0.742, 95% CI:0.711–0.772).
CONCLUSIONS:
Summer onset, elevated NAR, and decreased MPV help identify IgAV patients at high risk of GI bleeding. A model combining these factors allows effective risk stratification and supports targeted monitoring in clinical practice, particularly for summer-admitted patients with high neutrophil-to-albumin ratios.
