{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T13:48:46Z","timestamp":1793713726448,"version":"4.6.1"},"reference-count":35,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"unspecified","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,9,5]]},"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction IgA vasculitis (IgAV, formerly Henoch-Sch\u00f6nlein purpura) is a systemic small-vessel vasculitis. The aetiology of IgAV is multifactorial, involving environmental triggers in genetically susceptible individuals. Evolving socioeconomic and environmental factors may be altering the contemporary aetiological and precipitant spectrum of IgAV. Prospective observational studies are therefore crucial for elucidating disease management, prognostic factors and long-term outcomes. Although numerous studies exist on paediatric IgAV, prospective cohort data remain limited. This multicentre prospective observational study aims to characterise the natural history, aetiological\/precipitant spectrum, incidence and outcomes of gastrointestinal and renal involvement, factors influencing therapeutic efficacy and the predictive value of biomarkers for disease activity.<\/jats:title>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>We will recruit 478 paediatric patients with newly diagnosed IgAV across multiple centres. Participants will undergo prospective longitudinal assessment at disease onset and at 1, 3, 6 and 12 months postdiagnosis. Standardised evaluations will include clinical manifestations, physical examinations, laboratory parameters and patient-reported outcomes. The data will be analysed statistically with SPSS software (V.27.0), adopting a significance threshold of p&lt;0.05\u2009and using 95% CIs for statistical inference.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>This study has been approved by the Medical Ethics Committee of the First Affiliated Hospital of Guangxi Medical University (2024-K0480), the Ethics Committee of the First People\u2019s Hospital of Yulin (YLSY-IRB-SR-2025060), the Medical Research Ethics Committee of the Liuzhou Workers\u2019 Hospital (KY2024356) and the Ethics Committee of the Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region (No. (2025\u20131)003) and written informed consent was obtained from all the parents or guardians of the patients involved. It will be disseminated by publication of peer-reviewed manuscripts and presentation in abstract form at national and international scientific meetings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>ChiCTR2500099716.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-104835","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T09:01:19Z","timestamp":1758877279000},"page":"e104835","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Natural history, clinical outcomes and predictors of disease course in paediatric IgA vasculitis: protocol for a multicentre prospective cohort study in Guangxi Zhuang Autonomous Region, China"],"prefix":"10.1136","volume":"15","author":[{"given":"Huan-Huan","family":"Jiang","sequence":"first","affiliation":[{"name":"Department of Pediatrics, The first affiliated hospital of Guangxi medical university, Nanning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan-Yu","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Gastroenterology, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Guangxi Clinical Research Center for Pediatric Diseases, Nanning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The First People\u2019s Hospital of Yulin, Yulin, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rong-Jie","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The Workers\u2019 Hospital of Liuzhou, Liuzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The first affiliated hospital of Guangxi medical university, Nanning, China"},{"name":"Difficult and Critical illness Center, Pediatric Clinical Medical Research Center of Guangxi, Nanning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The first affiliated hospital of Guangxi medical university, Nanning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The first affiliated hospital of Guangxi medical university, Nanning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing-Wen","family":"Shan","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The first affiliated hospital of Guangxi medical university, Nanning, China"},{"name":"Difficult and Critical illness Center, Pediatric Clinical Medical Research Center of Guangxi, Nanning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5551-6782","authenticated-orcid":false,"given":"Xiu-Qi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, The first affiliated hospital of Guangxi medical university, Nanning, China"},{"name":"Difficult and Critical illness Center, Pediatric Clinical Medical Research Center of Guangxi, Nanning, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"2025092602002227000_15.9.e104835.1","unstructured":"Yang KK , Mao JH . Research Progress on Biological Markers of Henoch-Sch\u00f6nlein purpura Nephritis. Medical Research Journal 2024;53."},{"key":"2025092602002227000_15.9.e104835.2","doi-asserted-by":"crossref","first-page":"113063","DOI":"10.1016\/j.intimp.2024.113063","article-title":"Blood soluble CD89-IgA complex may be a potential biomarker for predicting multi-organ involvement, especially renal involvement in children with immunoglobulin A vasculitis","volume":"142","author":"Yu","year":"2024","journal-title":"Int Immunopharmacol"},{"key":"2025092602002227000_15.9.e104835.3","first-page":"683","article-title":"Exploring the mechanism of IgA vasculitis pathogenesis through the interaction of thrombin and inflammatory factors using urinary proteomics","volume":"26","author":"Liu","year":"2024","journal-title":"Zhongguo Dang Dai Er Ke Za Zhi"},{"key":"2025092602002227000_15.9.e104835.4","doi-asserted-by":"crossref","DOI":"10.7717\/peerj.18175","article-title":"The relationship between the severity and complications of Hen\u00f6ch-Sch\u00f6nlein purpura in children and dietary inflammatory index: a retrospective cohort study","volume":"12","author":"Chen","year":"2024","journal-title":"PeerJ"},{"key":"2025092602002227000_15.9.e104835.5","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1007\/s11739-023-03366-w","article-title":"Henoch-schonlein purpura following exposure to SARS-CoV2 vaccine or infection: a systematic review and a case report","volume":"19","author":"Di Vincenzo","year":"2024","journal-title":"Intern Emerg Med"},{"key":"2025092602002227000_15.9.e104835.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-009-1055-8"},{"key":"2025092602002227000_15.9.e104835.7","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-006-0266-6"},{"key":"2025092602002227000_15.9.e104835.8","article-title":"Gastrointestinal bleeding in children with Henoch-Sch\u00f6nlein purpura combined with prognostic nutrition index may predict endoscopic duodenal ulcers during hospitalization: A single-center retrospective case-control study","volume":"103","author":"Li","year":"2024","journal-title":"Medicine (Abingdon)"},{"key":"2025092602002227000_15.9.e104835.9","first-page":"26","article-title":"Current status of outcome indicators in clinical studies of abdominal Henoch-Schonlein purpura","volume":"15","author":"Liu","year":"2023","journal-title":"Chinese Journal of Evidence-Based Cardiovascular Medicine"},{"key":"2025092602002227000_15.9.e104835.10","unstructured":"Yahui C , Dasheng Y , He Z , et al . Progress of Clinical Research on IgA Vasculitis in Children. Journal of Clinical Pediatrics 2024;42."},{"key":"2025092602002227000_15.9.e104835.11","doi-asserted-by":"crossref","first-page":"868","DOI":"10.24953\/turkjped.2022.935","article-title":"A rare complication of IgA vasculitis: renal and intestinal ischemia successfully treated with plasmapheresis","volume":"65","author":"T\u00fcrkmen","year":"2023","journal-title":"Turk J Pediatr"},{"key":"2025092602002227000_15.9.e104835.12","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s40272-021-00464-0","article-title":"Management of IgA Vasculitis with Nephritis","volume":"23","author":"Delbet","year":"2021","journal-title":"Paediatr Drugs"},{"key":"2025092602002227000_15.9.e104835.13","doi-asserted-by":"crossref","DOI":"10.3389\/fped.2018.00421","article-title":"Childhood Vasculitis","volume":"6","author":"Schnabel","year":"2018","journal-title":"Front Pediatr"},{"key":"2025092602002227000_15.9.e104835.14","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1007\/s00431-019-03409-5","article-title":"Indications and efficiency of dapsone in IgA vasculitis (Henoch-Schonlein purpura): case series and a review of the literature","volume":"178","author":"Roman","year":"2019","journal-title":"Eur J Pediatr"},{"key":"2025092602002227000_15.9.e104835.15","first-page":"143","article-title":"Risk factors of renal involvement in children with primary Henoch-Schnlein purpura in the early stage","volume":"15","author":"Sun","year":"2019","journal-title":"Chinese Journal of Maternal and Child Health"},{"key":"2025092602002227000_15.9.e104835.16","unstructured":"Lan LC . [Significance of IL-17and its related cytokines in peripheralblood and intestinal mucosa of childrenwith abdominal henoch-schonleinpurpura]. Master. Guangxi Medical University, 2019"},{"key":"2025092602002227000_15.9.e104835.17","first-page":"336","article-title":"Clinical analysis of 118 cases of henoch-schonlein purpura in children","volume":"43","author":"Zhu","year":"2014","journal-title":"Journal of Clinical Dermatology"},{"key":"2025092602002227000_15.9.e104835.18","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1097\/MOP.0000000000001120","article-title":"IgA vasculitis nephritis","volume":"34","author":"N\u00fcsken","year":"2022","journal-title":"Curr Opin Pediatr"},{"key":"2025092602002227000_15.9.e104835.19","doi-asserted-by":"crossref","first-page":"3117","DOI":"10.1007\/s00431-024-05573-9","article-title":"Exploring potential predictors of Henoch-Sch\u00f6nlein purpura nephritis: a pilot investigation on urinary metabolites","volume":"183","author":"Yu","year":"2024","journal-title":"Eur J Pediatr"},{"key":"2025092602002227000_15.9.e104835.20","first-page":"256","article-title":"Biomarkers to predict kidney outcomes in children with IgA vasculitis","volume":"77","author":"Williams","year":"2025","journal-title":"Minerva Pediatr (Torino)"},{"key":"2025092602002227000_15.9.e104835.21","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2005.046300"},{"key":"2025092602002227000_15.9.e104835.22","first-page":"647","article-title":"Evidence-based guideline for diagnosis and treatment of Henoch-Schonlein purpura nephritis (2016)","volume":"55","year":"2017","journal-title":"Zhonghua Er Ke Za Zhi"},{"key":"2025092602002227000_15.9.e104835.23","doi-asserted-by":"crossref","first-page":"3055","DOI":"10.3390\/jcm14093055","article-title":"Laboratory Findings and Clinical Features in IgA Vasculitis: Identifying Predictors of Kidney Involvement and Disease Relapse in Pediatric Patients","volume":"14","author":"Podraza","year":"2025","journal-title":"J Clin Med"},{"key":"2025092602002227000_15.9.e104835.24","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-021-05863-9"},{"key":"2025092602002227000_15.9.e104835.25","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-014-0534-5"},{"key":"2025092602002227000_15.9.e104835.26","doi-asserted-by":"crossref","first-page":"3721","DOI":"10.1007\/s00467-023-06023-8","article-title":"Clinical course and management of children with IgA vasculitis with nephritis","volume":"38","author":"Stone","year":"2023","journal-title":"Pediatr Nephrol"},{"key":"2025092602002227000_15.9.e104835.27","doi-asserted-by":"crossref","first-page":"513","DOI":"10.17219\/acem\/112566","article-title":"IgA vasculitis with nephritis in children","volume":"29","author":"Dyga","year":"2020","journal-title":"Adv Clin Exp Med"},{"key":"2025092602002227000_15.9.e104835.28","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0167346","article-title":"Risk Factors Associated with Renal Involvement in Childhood Henoch-Sch\u00f6nlein Purpura: A Meta-Analysis","volume":"11","author":"Chan","year":"2016","journal-title":"PLoS ONE"},{"key":"2025092602002227000_15.9.e104835.29","doi-asserted-by":"crossref","first-page":"2997","DOI":"10.1007\/s00467-024-06432-3","article-title":"Predicting renal damage in children with IgA vasculitis by machine learning","volume":"39","author":"Pan","year":"2024","journal-title":"Pediatr Nephrol"},{"key":"2025092602002227000_15.9.e104835.30","doi-asserted-by":"crossref","unstructured":"Li Y , Zhang X , Liu H , et al . Severe gastrointestinal involvement in pediatric IgA vasculitis: a retrospective single-center cohort study in China. Front Pediatr 2023;11. doi:10.3389\/fped.2023.1194214","DOI":"10.3389\/fped.2023.1194214"},{"key":"2025092602002227000_15.9.e104835.31","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1159\/000519665","article-title":"Predicting Severe Renal and Gastrointestinal Involvement in Childhood Immunoglobulin A Vasculitis with Routine Laboratory Parameters","volume":"238","author":"Song","year":"2022","journal-title":"Dermatology"},{"key":"2025092602002227000_15.9.e104835.32","doi-asserted-by":"crossref","first-page":"999","DOI":"10.17219\/acem\/138906","article-title":"The relationship between monocyte-to-lymphocyte ratio and the risk of gastrointestinal system involvement in children with IgA vasculitis: A preliminary report","volume":"30","author":"Yuan","year":"2021","journal-title":"Adv Clin Exp Med"},{"key":"2025092602002227000_15.9.e104835.33","doi-asserted-by":"crossref","DOI":"10.3389\/fimmu.2021.668974","article-title":"The Involvement of Neutrophil Extracellular Traps in Disease Activity Associated With IgA Vasculitis","volume":"12","author":"Chen","year":"2021","journal-title":"Front Immunol"},{"key":"2025092602002227000_15.9.e104835.34","doi-asserted-by":"publisher","DOI":"10.1007\/s00467-010-1444-y"},{"key":"2025092602002227000_15.9.e104835.35","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e32835d8e2a"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-104835","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T09:01:26Z","timestamp":1758877286000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-104835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":35,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9,26]]},"published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1136\/bmjopen-2025-104835"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-104835","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]}}}