| Theme | Gastrointestinal Disease Due to Blood Flow Damage | |
|---|---|---|
| Title | Gastrointestinal Involvement in IgA Vasculitis | |
| Publish Date | 2019/01 | |
| Author | Keijiro Okada | Department of Gastroenterology, Japanese Red Cross Wakayama Medical Center |
| Author | Yasuhiro Tani | Department of Gastroenterology, Japanese Red Cross Wakayama Medical Center |
| Author | Kosuke Minaga | Department of Gastroenterology, Japanese Red Cross Wakayama Medical Center |
| Author | Yukitaka Yamashita | Department of Gastroenterology, Japanese Red Cross Wakayama Medical Center |
| [ Summary ] | IgA vasculitis is a systemic vasculitis affecting the small vessels of the skin, joints, the gastrointestinal (GI) tract, and the kidneys. The primary clinical manifestations are abdominal pain, nausea, vomiting, and melena, which are attributable to bowel ischemia and edema. Serious complications include intestinal invagination, intestinal infarction and perforation. Endoscopic features of this condition are diffuse mucosal redness, petechiae, as well as hemorrhagic erosions and ulcers. IgA vasculitis affects the entire GI tract. GI involvement is often observed predominantly in the small bowel, however, the esophagus, stomach, terminal ileum, and the colon may also be affected. Diagnosing IgA vasculitis may be difficult, particularly in patients with abdominal symptoms that precede the appearance of the characteristic palpable purpura. Typical endoscopic findings may alert gastroenterologists to consider this condition (to ensure early diagnosis and prompt treatment) in patients with a high clinical suspicion of this disease even in the absence of characteristic skin lesions. Treatment is often symptomatic because the disease usually runs a benign course. Steroid therapy may be required in patients with severe GI complications or the development of proliferative glomerulonephritis. |
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