IgA Vasculitis Diagnosed with Extensive Duodenal Ulcer without Purpura, Report of a Case Kiyotaka Okawa 1 , Wataru Ueda 1 , Tetsuya Aoki 1 , Koji Sano 1 , Masato Miyano 1 , Hiroshi Ono 1 , Shusuke Nakauchi 1 , Etsuji Kawamura 1 , Seiko Yamaguchi 1 , Osamu Kurai 1 , Hideki Fujii 2 , Ryota Nakamura 3 , Keiko Yamagami 3 , Masayuki Onodera 4 1Department of Gastroenterology, Osaka City Juso Hospital, Osaka, Japan 2Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan 3Department of Gastroenterology, Osaka City General Hospital, Osaka, Japan 4Department of Pathology, Kawanishi City Hospital, Kawanishi, Japan Keyword: IgA血管炎 , 十二指腸潰瘍 , 紫斑なし , 腸管壁肥厚 , 凝固第XIII因子 pp.1537-1543
Published Date 2018/10/25
DOI https://doi.org/10.11477/mf.1403201505
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 A 70's-year-old man was admitted to our hospital with vomiting, diarrhea, and abdominal pain. The administration of antibiotics did not improve his symptoms. Eight days later, the abdominal pain gradually increased, and a fever appeared. Laboratory data showed high levels of CRP and low serum albumin levels. Abdominal CT revealed a severely thickened wall from the second portion of the duodenum to the jejunum. Small intestinal endoscopy revealed extensive ulcers and remaining insular mucosa from the second portion of the duodenum to the upper part of the jejunum. He was diagnosed with IgA vasculitis based on continued abdominal pain, CT findings, and endoscopic findings despite no purpura. After eight days of hospitalization, a glucocorticoid was administered, and his symptoms gradually improved. At a later date, laboratory data showed low levels of factor XIII, and the pathological examination of the biopsied specimens obtained from the extensive duodenal ulcer was consistent with IgA vasculitis. We experienced a case of IgA vasculitis in an elderly man with extensive duodenal ulcers without purpura and reviewed the relevant literature.

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