Immunoglobulin A vasculitis (IgAV) is a common immune complex-mediated systemic small vessel vasculitis in children. Gastrointestinal (GI) involvement significantly impacts early prognosis and may precede the appearance of purpura, complicating timely diagnosis. We retrospectively analyzed 195 cases of children diagnosed with IgAV from June 2019 to April 2024, among whom 62 cases had GI involvement. Clinical and laboratory data were collected. Children in the IgAV GI involvement group exhibited lower rates of arthritis/arthralgia and significantly higher levels of neutrophil-to-lymphocyte ratio (NLR) (P = .002, OR = 1.455), platelet count (P = .020, OR = 1.005), and uric acid (P = .017, OR = 1.005), with lower immunoglobulin G (IgG) (P = .004, OR = .818) levels. Multivariate analysis identified NLR, platelet count, uric acid, and IgG as independent predictors. The combined model showed good discrimination (area under the curve [AUC] = 0.753) and high specificity (93.2%). Elevated NLR, platelet count, uric acid, and reduced IgG are independent risk factors for GI involvement in pediatric IgAV and may facilitate early risk stratification.
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