How Common Is Gastrointestinal Involvement in Adult IgA Vasculitis?

Gastrointestinal involvement is common in adults with IgA vasculitis, according findings of a new study.

The researchers conducted a multicenter retrospective survey in France of 260 adults with IgA vasculitis, formerly known as Henoch-Schönlein purpura. 

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In all, 53% of the participants had gastrointestinal involvement. 

Abdominal pain was an initial manifestation among 99% of the participants. Other initial manifestations included intestinal bleeding (which affected 31% of the participants), diarrhea (26% of the participants), and acute surgical abdomen (4% of the participants). Abdominal imaging showed that 61% of participants had thickening of the intestinal wall. Endoscopy identified abnormalities, usually mucosal ulcerations, in 87% of the participants.

Participants with gastrointestinal involvement were younger, had more constitutional symptoms and joint involvement, and had higher levels of C-reactive protein compared with participants without gastrointestinal involvement.

Clinical response, relapse rates, all-cause mortality, and IgA vasculitis-related mortality were comparable between participants with and without gastrointestinal involvement. Deaths related to gastrointestinal involvement were caused by intestinal perforation and mesenteric ischemia, the researchers reported.

“Immunosuppressants should not be preferred as first-line therapy for [patients with gastrointestinal involvement] but may be required in case of acute surgical abdomen,” the researchers concluded.

—Jolynn Tumolo

Reference:

Audemard-Verger A, Pillebout E, Amoura Z, et al. Gastrointestinal involvement in adult IgA vasculitis (Henoch-Schönlein purpura): updated picture from a French multicentre and retrospective series of 260 cases. Rheumatology (Oxford). 2020;59(10):3050-3057. https://doi.org/10.1093/rheumatology/keaa104