Severe Colitis Secondary to IgA Vasculitis in Elderly

Zivari, Kaveh; Kantrowitz, Michael; Niknam, Negar; Mayer, Ira; Rahmani, Rabin

doi:10.14309/00000434-201810001-01578

Cited by 1 publication

(3 citation statements)

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“…Although evidence in the elderly has not been established, studies in children have shown an increased remission rate with the combination of azathioprine and corticosteroids [3]. Case reports of IgA vasculitis in the elderly have reported comparable results [2,14,15]. In this case, azathioprine effectively suppresses the symptoms and tapers the prednisolone dose.…”

Section: Discussionmentioning

confidence: 72%

“…One useful immunosuppressant for IgA vasculitis is azathioprine, which should be used in combination with prednisolone in elderly patients. Azathioprine inhibits leukocyte proliferation by blocking purine synthesis [2,14,15]. Different mechanisms may contribute to remission and shortening IgA vasculitis time.…”

Section: Discussionmentioning

confidence: 99%

“…Different mechanisms may contribute to remission and shortening IgA vasculitis time. Since azathioprine is used to treat Crohn's disease and ulcerative colitis, which are caused by B-cell abnormalities, it is suggested to be more effective than other immunosuppressants for IgA vasculitis with abdominal manifestations [2,14,15]. Although evidence in the elderly has not been established, studies in children have shown an increased remission rate with the combination of azathioprine and corticosteroids [3].…”

Section: Discussionmentioning

confidence: 99%

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Refractory Immunoglobulin A (IgA) Vasculitis in an Elderly Patient: A Case Report

Nishikura¹,

Ohta²,

Katagiri³

et al. 2022

Cureus

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Immunoglobulin A (IgA) vasculitis is small-vessel arteritis triggered by autoimmunity and allergies. IgA vasculitis among elderly patients is rare, and there is a lack of evidence regarding the choice of medicine and treatment duration. The main treatment for IgA vasculitis is steroids which can be cured with a small dose of prednisolone without immunosuppressants. Here, we report a case of a 90-year-old patient with the chief complaint of appetite loss and purpura on the legs who was diagnosed with IgA vasculitis based on biopsy results. The patient was initially treated with prednisolone effectively but exacerbated with steroid tapering, eventually requiring the use of an immunosuppressant. This case highlights the importance of monitoring the symptoms of IgA vasculitis while tapering steroids and clarifying the timing of immunosuppressant initiation.

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