Widespread involvement of purpura related to gastrointestinal involvements in adults with immunoglobulin A vasculitis
Abstract Immunoglobulin A vasculitis (IgAV) is a type of vasculitis affecting small vessels with deposition of immune complexes consisting of IgA and complement component 3. IgAV involves the skin, gastrointestinal (GI) tract, joints, and kidneys. Adult patients have higher risks of gastrointestinal...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2020-10-01
|
| Series: | Journal of Cutaneous Immunology and Allergy |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cia2.12136 |
| _version_ | 1797335352442093568 |
|---|---|
| author | Noriko Kubota Sae Inoue Akimasa Saito Ryota Tanaka Yoshiyuki Nakamura Yosuke Ishitsuka Jun‐ichi Furuta Yasuhiro Fujisawa Naoko Okiyama |
| author_facet | Noriko Kubota Sae Inoue Akimasa Saito Ryota Tanaka Yoshiyuki Nakamura Yosuke Ishitsuka Jun‐ichi Furuta Yasuhiro Fujisawa Naoko Okiyama |
| author_sort | Noriko Kubota |
| collection | DOAJ |
| description | Abstract Immunoglobulin A vasculitis (IgAV) is a type of vasculitis affecting small vessels with deposition of immune complexes consisting of IgA and complement component 3. IgAV involves the skin, gastrointestinal (GI) tract, joints, and kidneys. Adult patients have higher risks of gastrointestinal tract involvement than children. To investigate the risk factors of the GI tract involvements in adult IgAV patients, we enrolled 29 adult (aged ≥ 20 years) Japanese patients recently (from 2013 to 2019) histopathologically diagnosed with IgAV and classified them into the GI lesion (+) group and the GI lesion (−) group. All patients presented with purpura on the lower extremities; moreover, GI lesion (+) patients presented significantly more with extensive purpura on the upper extremities, and low levels of factor XIII activity (≤70%) than gastrointestinal lesion (−) patients (87.5% vs 28.6% [P = .004]; odds ratio [OR], 17.5; 95% confidence interval [CI], 2.4 to 366], and 57.1% vs 14.3% [P = .04]; OR, 8; 95% CI, 1.06 to 83.9, respectively). There was no significant difference between the two groups in the populations with extensive purpura on the trunk, arthralgia, hematuria, proteinuria, or elevated serum levels of C‐reactive protein or IgA. Widespread purpura on the upper extremities accompanied by a low factor XIII activity is a suggestive factor for severe GI lesions in adult IgAV patients. |
| first_indexed | 2024-03-08T08:35:45Z |
| format | Article |
| id | doaj.art-de0a4553819b469c80fb82218a790a2d |
| institution | Directory Open Access Journal |
| issn | 2574-4593 |
| language | English |
| last_indexed | 2024-03-08T08:35:45Z |
| publishDate | 2020-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Journal of Cutaneous Immunology and Allergy |
| spelling | doaj.art-de0a4553819b469c80fb82218a790a2d2024-02-02T01:37:29ZengFrontiers Media S.A.Journal of Cutaneous Immunology and Allergy2574-45932020-10-013510410810.1002/cia2.12136Widespread involvement of purpura related to gastrointestinal involvements in adults with immunoglobulin A vasculitisNoriko Kubota0Sae Inoue1Akimasa Saito2Ryota Tanaka3Yoshiyuki Nakamura4Yosuke Ishitsuka5Jun‐ichi Furuta6Yasuhiro Fujisawa7Naoko Okiyama8Department of Dermatology Faculty of Medicine University of Tsukuba Tsukuba JapanDepartment of Dermatology Faculty of Medicine University of Tsukuba Tsukuba JapanDepartment of Dermatology Faculty of Medicine University of Tsukuba Tsukuba JapanDepartment of Dermatology Faculty of Medicine University of Tsukuba Tsukuba JapanDepartment of Dermatology Faculty of Medicine University of Tsukuba Tsukuba JapanDepartment of Dermatology Faculty of Medicine University of Tsukuba Tsukuba JapanDepartment of Dermatology Faculty of Medicine University of Tsukuba Tsukuba JapanDepartment of Dermatology Faculty of Medicine University of Tsukuba Tsukuba JapanDepartment of Dermatology Faculty of Medicine University of Tsukuba Tsukuba JapanAbstract Immunoglobulin A vasculitis (IgAV) is a type of vasculitis affecting small vessels with deposition of immune complexes consisting of IgA and complement component 3. IgAV involves the skin, gastrointestinal (GI) tract, joints, and kidneys. Adult patients have higher risks of gastrointestinal tract involvement than children. To investigate the risk factors of the GI tract involvements in adult IgAV patients, we enrolled 29 adult (aged ≥ 20 years) Japanese patients recently (from 2013 to 2019) histopathologically diagnosed with IgAV and classified them into the GI lesion (+) group and the GI lesion (−) group. All patients presented with purpura on the lower extremities; moreover, GI lesion (+) patients presented significantly more with extensive purpura on the upper extremities, and low levels of factor XIII activity (≤70%) than gastrointestinal lesion (−) patients (87.5% vs 28.6% [P = .004]; odds ratio [OR], 17.5; 95% confidence interval [CI], 2.4 to 366], and 57.1% vs 14.3% [P = .04]; OR, 8; 95% CI, 1.06 to 83.9, respectively). There was no significant difference between the two groups in the populations with extensive purpura on the trunk, arthralgia, hematuria, proteinuria, or elevated serum levels of C‐reactive protein or IgA. Widespread purpura on the upper extremities accompanied by a low factor XIII activity is a suggestive factor for severe GI lesions in adult IgAV patients.https://doi.org/10.1002/cia2.12136adultfactor XIII activitygastrointestinal involvementimmunoglobulin A vasculitispalpable purpura |
| spellingShingle | Noriko Kubota Sae Inoue Akimasa Saito Ryota Tanaka Yoshiyuki Nakamura Yosuke Ishitsuka Jun‐ichi Furuta Yasuhiro Fujisawa Naoko Okiyama Widespread involvement of purpura related to gastrointestinal involvements in adults with immunoglobulin A vasculitis Journal of Cutaneous Immunology and Allergy adult factor XIII activity gastrointestinal involvement immunoglobulin A vasculitis palpable purpura |
| title | Widespread involvement of purpura related to gastrointestinal involvements in adults with immunoglobulin A vasculitis |
| title_full | Widespread involvement of purpura related to gastrointestinal involvements in adults with immunoglobulin A vasculitis |
| title_fullStr | Widespread involvement of purpura related to gastrointestinal involvements in adults with immunoglobulin A vasculitis |
| title_full_unstemmed | Widespread involvement of purpura related to gastrointestinal involvements in adults with immunoglobulin A vasculitis |
| title_short | Widespread involvement of purpura related to gastrointestinal involvements in adults with immunoglobulin A vasculitis |
| title_sort | widespread involvement of purpura related to gastrointestinal involvements in adults with immunoglobulin a vasculitis |
| topic | adult factor XIII activity gastrointestinal involvement immunoglobulin A vasculitis palpable purpura |
| url | https://doi.org/10.1002/cia2.12136 |
| work_keys_str_mv | AT norikokubota widespreadinvolvementofpurpurarelatedtogastrointestinalinvolvementsinadultswithimmunoglobulinavasculitis AT saeinoue widespreadinvolvementofpurpurarelatedtogastrointestinalinvolvementsinadultswithimmunoglobulinavasculitis AT akimasasaito widespreadinvolvementofpurpurarelatedtogastrointestinalinvolvementsinadultswithimmunoglobulinavasculitis AT ryotatanaka widespreadinvolvementofpurpurarelatedtogastrointestinalinvolvementsinadultswithimmunoglobulinavasculitis AT yoshiyukinakamura widespreadinvolvementofpurpurarelatedtogastrointestinalinvolvementsinadultswithimmunoglobulinavasculitis AT yosukeishitsuka widespreadinvolvementofpurpurarelatedtogastrointestinalinvolvementsinadultswithimmunoglobulinavasculitis AT junichifuruta widespreadinvolvementofpurpurarelatedtogastrointestinalinvolvementsinadultswithimmunoglobulinavasculitis AT yasuhirofujisawa widespreadinvolvementofpurpurarelatedtogastrointestinalinvolvementsinadultswithimmunoglobulinavasculitis AT naokookiyama widespreadinvolvementofpurpurarelatedtogastrointestinalinvolvementsinadultswithimmunoglobulinavasculitis |