{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T16:17:32Z","timestamp":1785773852668,"version":"3.56.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T00:00:00Z","timestamp":1685923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The severe acute abdomen associated with Henoch-Schonlein purpura (HSP) is an acute intussusception (AI). There is no reliable specific marker for AI with abdominal-type HSP. The serum total bile acid (TBA) level is a new prognostic marker associated with the severity of intestinal inflammation. The purpose of this study was to identify the prognostic value of serum TBA levels for the diagnosis of AI in children with abdominal-type HSP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study of 708 patients with abdominal-type HSP was conducted, with demographic data, clinical symptoms, hepatic function index, immune function markers, and clinical outcomes assessed. Patients were divided into two groups: HSP (613 patients) and HSP with AI (95 patients). The data were analysed using SPSS 22.0.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 708 patients, the serum TBA levels were higher in the HSP with AI group than in the HSP group (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05). Logistic regression analysis showed that vomiting (OR\u2009=\u2009396.492, 95% CI\u2009=\u200914.93\u201310,529.67, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001), haematochezia (OR\u2009=\u200987.436, 95% CI\u2009=\u20095.944\u20131,286.214, <jats:italic>P<\/jats:italic>\u2009=\u20090.001), TBA (OR\u2009=\u200916.287, 95% CI\u2009=\u20094.83\u201354.922, <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001), and D-dimer (OR\u2009=\u20095.987, 95% CI\u2009=\u20091.892\u201315.834, <jats:italic>P<\/jats:italic>\u2009=\u20090.003) were independent risk factors for abdominal-type HSP with AI. Receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off serum TBA value (sensitivity\u2009=\u200991.58%, specificity\u2009=\u200984.67%, AUC\u2009=\u200993.6524%) was &amp;gt;3\u2005\u03bcmol\/L for predicting AI in children with abdominal-type HSP. In this group of HSP patients with AI, a serum TBA level \u22656.98\u2005\u03bcmol\/L was significantly associated with an increased incidence of operative treatment (51.85% vs. 75.61%, <jats:italic>P<\/jats:italic>\u2009=\u20090.0181), intestinal necrosis (9.26% vs. 29.27%, <jats:italic>P<\/jats:italic>\u2009=\u20090.0117), and length of hospital stay [15.76\u2009\u00b1\u20095.31 vs. 10.98\u2009\u00b1\u20092.83 (days), <jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.0001].<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In children with HSP and AI, the serum TBA level was significantly higher. A novel but promising haematological indicator, the serum TBA level, helps identify HSP with and without AI and predicts intestinal necrosis in HSP with AI.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2023.1183470","type":"journal-article","created":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T04:38:15Z","timestamp":1685939895000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Serum total bile acid levels assist in the prediction of acute intussusception with abdominal type Henoch-Schonlein purpura in children"],"prefix":"10.3389","volume":"11","author":[{"given":"Sijie","family":"Yu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maoyuan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuying","family":"Tu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenhua","family":"Guo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1016\/j.semarthrit.2005.08.007","article-title":"Henoch-Schonlein purpura in childhood: epidemiological and clinical analysis of 150 cases over a 5-year period and review of literature","volume":"35","author":"Trapani","year":"2005","journal-title":"Semin Arthritis Rheum"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2011","DOI":"10.1007\/s10620-007-0147-0","article-title":"Gastrointestinal manifestations of Henoch-Schonlein Purpura","volume":"53","author":"Ellen","year":"2008","journal-title":"Dig Dis Sci"},{"key":"B3","doi-asserted-by":"publisher","first-page":"976","DOI":"10.1016\/S0140-6736(07)60474-7","article-title":"Clinical update: Henoch-Schonlein purpura","volume":"369","author":"Saulsbury","year":"2007","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1542\/peds.2004-0390","article-title":"Intussusception in early childhood: a cohort study of 1.7 million children","volume":"114","author":"Fischer","year":"2004","journal-title":"Pediatrics"},{"key":"B5","first-page":"197","article-title":"Henoch-Sch\u00f6nlein purpura complicated by appendicitis, intussusception and ureteritis","volume":"35","author":"Jasi\u0107","year":"2011","journal-title":"Coll Antropol"},{"key":"B6","doi-asserted-by":"publisher","first-page":"265","DOI":"10.2174\/18756336MTA2lNDYc2","article-title":"Henoch-Sch\u00f6nlein purpura in children: an updated review","volume":"16","author":"Leung","year":"2020","journal-title":"Curr Pediatr Rev"},{"key":"B7","doi-asserted-by":"publisher","first-page":"6244","DOI":"10.12998\/wjcc.v9.i22.6244","article-title":"Risk factors for intussusception in children with henoch-sch\u00f6nlein purpura: a case-control study","volume":"9","author":"Zhao","year":"2021","journal-title":"World J Clin Cases"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1111\/nmo.12370","article-title":"The role of bile acids in functional GI disorders","volume":"26","author":"Appleby","year":"2014","journal-title":"Neurogastroenterol Motil"},{"key":"B9","doi-asserted-by":"publisher","first-page":"3143","DOI":"10.3390\/nu13093143","article-title":"Bile acid-gut microbiota axis in inflammatory bowel disease: from bench to bedside","volume":"13","author":"Yang","year":"2021","journal-title":"Nutrients"},{"key":"B10","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1038\/s41575-019-0258-z","article-title":"Gut microbiota-derived metabolites as key actors in inflammatory bowel disease","volume":"17","author":"Lavelle","year":"2020","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1120","DOI":"10.1016\/j.dld.2021.04.022","article-title":"Faecal bile acids and colonic bile acid membrane receptor correlate with symptom severity of diarrhoea-predominant irritable bowel syndrome: a pilot study","volume":"53","author":"Wei","year":"2021","journal-title":"Dig Liver Dis"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.intimp.2018.03.003","article-title":"Gut microbiota dysbiosis is associated with Henoch-Sch\u00f6nlein purpura in children","volume":"58","author":"Wang","year":"2018","journal-title":"Int Immunopharmacol"},{"key":"B13","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/j.intimp.2018.10.017","article-title":"Oral microbiota dysbiosis and its association with Henoch-Sch\u00f6nlein purpura in children","volume":"65","author":"Chen","year":"2018","journal-title":"Int Immunopharmacol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2569","DOI":"10.1002\/art.27584","article-title":"Rheumatoid arthritis classification criteria: an American College of Rheumatology\/European league against rheumatism collaborative initiative","volume":"62","author":"Aletaha","year":"2010","journal-title":"Arthritis Rheum"},{"key":"B15","doi-asserted-by":"publisher","first-page":"127","DOI":"10.2165\/00128071-200910020-00006","article-title":"Periumbilical purpura prior to gastrointestinal involvement in Henoch-Sch\u00f6nlein purpura","volume":"10","author":"Brown","year":"2009","journal-title":"Am J Clin Dermatol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1016\/j.jpedsurg.2005.05.001","article-title":"Contrast enema in children with Henoch-Sch\u00f6nlein purpura","volume":"40","author":"Schwab","year":"2005","journal-title":"J Pediatr Surg"},{"key":"B17","first-page":"A09200680","article-title":"Early diagnosis and treatment for intussusception in children is mandatory","volume":"68","author":"Kobborg","year":"2021","journal-title":"Dan Med J"},{"key":"B18","doi-asserted-by":"publisher","first-page":"423","DOI":"10.1046\/j.1442-200X.2001.01417.x","article-title":"Henoch-Sch\u00f6nlein purpura-related intestinal perforation: a steroid complication?","volume":"43","author":"Yavuz","year":"2001","journal-title":"Pediatr Int"},{"key":"B19","doi-asserted-by":"publisher","first-page":"e018604","DOI":"10.1136\/bmjopen-2017-018604","article-title":"Risk factors for recurrent intussusception in children: a retrospective cohort study","volume":"7","author":"Guo","year":"2017","journal-title":"BMJ Open"},{"key":"B20","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1177\/000992280404300405","article-title":"The diagnosis of intussusception","volume":"43","author":"Klein","year":"2004","journal-title":"Clin Pediatr"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1077","DOI":"10.1002\/jum.15504","article-title":"Ultrasonographic diagnosis of intussusception in children: a systematic review and meta-analysis","volume":"40","author":"Li","year":"2021","journal-title":"J Ultrasound Med"},{"key":"B22","doi-asserted-by":"publisher","first-page":"39","DOI":"10.5223\/pghn.2015.18.1.39","article-title":"Laboratory markers indicating gastrointestinal involvement of Henoch-Sch\u00f6nlein purpura in children","volume":"18","author":"Hong","year":"2015","journal-title":"Pediatr Gastroenterol Hepatol Nutr"},{"key":"B23","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1111\/j.1538-7836.2012.04637.x","article-title":"D-dimer testing in the diagnosis of cerebral vein thrombosis: a systematic review and a meta-analysis of the literature","volume":"10","author":"Dentali","year":"2012","journal-title":"J Thromb Haemost"},{"key":"B24","doi-asserted-by":"publisher","first-page":"3783","DOI":"10.1007\/s10067-022-06323-8","article-title":"Clinical analysis of 99 children with Henoch-Sch\u00f6nlein purpura complicated with overt gastrointestinal bleeding","volume":"41","author":"Yang","year":"2022","journal-title":"Clin Rheumatol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1097\/MOG.0000000000000820","article-title":"Bile acids, bile pigments and colorectal cancer risk","volume":"38","author":"Kuhls","year":"2022","journal-title":"Curr Opin Gastroenterol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1172\/JCI130976","article-title":"A clostridia-rich microbiota enhances bile acid excretion in diarrhea-predominant irritable bowel syndrome","volume":"130","author":"Zhao","year":"2020","journal-title":"J Clin Invest"},{"key":"B27","doi-asserted-by":"publisher","first-page":"531","DOI":"10.1136\/gutjnl-2012-302578","article-title":"Connecting dysbiosis, bile-acid dysmetabolism and gut inflammation in inflammatory bowel diseases","volume":"62","author":"Duboc","year":"2013","journal-title":"Gut"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1005","DOI":"10.1111\/j.1553-2712.2001.tb01103.x","article-title":"Different management options for anaphylactoid purpura with intussusception: a case report","volume":"8","author":"Li","year":"2001","journal-title":"Acad Emerg Med"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1183470\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,5]],"date-time":"2023-06-05T04:38:17Z","timestamp":1685939897000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1183470\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,5]]},"references-count":28,"alternative-id":["10.3389\/fped.2023.1183470"],"URL":"https:\/\/doi.org\/10.3389\/fped.2023.1183470","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,5]]},"article-number":"1183470"}}