Coagulation and fibrinolysis biomarkers associated with gastrointestinal bleeding in children with immunoglobulin A vasculitis: a retrospective cohort study.
- 1Department of Laboratory Medicine, Children's Hospital of Soochow University, Suzhou, Jiangsu Province, China.
Abstract
This study aimed to explore alterations of soluble thrombomodulin (sTM), thrombin-antithrombin complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC), tissue plasminogen activator-inhibitor complex (t-PAIC), and D-dimer in children with immunoglobulin A vasculitis (IgAV). We further evaluated the associations of these hemostatic biomarkers and clinical features with gastrointestinal (GI) bleeding in this cohort of patients. A retrospective cohort study was conducted at our hospital between September 2021 and April 2025, enrolling 126 consecutive children diagnosed with IgAV. Among these, 44 children presented with GI bleeding and 20 developed overt GI bleeding. Univariate and multivariate logistic regression analyses were performed to identify associated factors for GI bleeding in IgAV children. Moreover, the threshold values were assessed by receiver operating characteristic (ROC) curve analysis. There were no significant differences in age, gender, sTM and t-PAIC between GI bleeding and no-GI-bleeding groups in children with IgAV. Among IgAV children, those with GI bleeding had significantly higher neutrophils, neutrophil-to-lymphocyte ratio (NLR), fibrinogen (FIB), TAT, PIC and D-dimer levels than those without GI bleeding, along with decreased serum immunoglobulin G (IgG). Children with overt bleeding had prolonged hospital stay, higher dose of methylprednisolone administration and elevated serum IgM than those with occult bleeding. Multivariate regression analysis revealed that PIC (odds ratio [OR] = 1.888, 95% confidence intervals [CI] 1.013-3.518, P = 0.045; area under the curve [AUC] = 0.687) was independently associated with higher odds of GI bleeding with IgAV in childhood, and serum IgG (OR = 0.843, 95%CI: 0.737-0.965, P = 0.013). The AUC of combined model was 0.737. Increased PIC levels and decreased serum IgG are closely correlated with GI bleeding in children with IgAV.
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BibTeX
@article{chen2026coagulation,
title = {{Coagulation and fibrinolysis biomarkers associated with gastrointestinal bleeding in children with immunoglobulin A vasculitis: a retrospective cohort study.}},
author = {Fang Chen and Hanjun Shen and Xuejun Shao and Jia Wei},
journal = {Frontiers in pediatrics},
year = {2026},
month = oct,
doi = {10.3389/fped.2026.1886693},
url = {https://europepmc.org/article/MED/42953036},
note = {CC BY},
}
RIS
TY - JOUR
TI - Coagulation and fibrinolysis biomarkers associated with gastrointestinal bleeding in children with immunoglobulin A vasculitis: a retrospective cohort study.
AU - Fang Chen
AU - Hanjun Shen
AU - Xuejun Shao
AU - Jia Wei
PY - 2026
DA - 2026/10/14
JO - Frontiers in pediatrics
DO - 10.3389/fped.2026.1886693
UR - https://europepmc.org/article/MED/42953036
AB - This study aimed to explore alterations of soluble thrombomodulin (sTM), thrombin-antithrombin complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC), tissue plasminogen activator-inhibitor complex (t-PAIC), and D-dimer in children with immunoglobulin A vasculitis (IgAV). We further evaluated the associations of these hemostatic biomarkers and clinical features with gastrointestinal (GI) bleeding in this cohort of patients. A retrospective cohort study was conducted at our hospital between September 2021 and April 2025, enrolling 126 consecutive children diagnosed with IgAV. Among these, 44 children presented with GI bleeding and 20 developed overt GI bleeding. Univariate and multivariate logistic regression analyses were performed to identify associated factors for GI bleeding in IgAV children. Moreover, the threshold values were assessed by receiver operating characteristic (ROC) curve analysis. There were no significant differences in age, gender, sTM and t-PAIC between GI bleeding and no-GI-bleeding groups in children with IgAV. Among IgAV children, those with GI bleeding had significantly higher neutrophils, neutrophil-to-lymphocyte ratio (NLR), fibrinogen (FIB), TAT, PIC and D-dimer levels than those without GI bleeding, along with decreased serum immunoglobulin G (IgG). Children with overt bleeding had prolonged hospital stay, higher dose of methylprednisolone administration and elevated serum IgM than those with occult bleeding. Multivariate regression analysis revealed that PIC (odds ratio [OR] = 1.888, 95% confidence intervals [CI] 1.013-3.518, P = 0.045; area under the curve [AUC] = 0.687) was independently associated with higher odds of GI bleeding with IgAV in childhood, and serum IgG (OR = 0.843, 95%CI: 0.737-0.965, P = 0.013). The AUC of combined model was 0.737. Increased PIC levels and decreased serum IgG are closely correlated with GI bleeding in children with IgAV.
SN - 2296-2360
ER -