Article in Japanese

Two cases of IgA vasculitis with sole abdominal symptoms without purpura

Makiko ISHIKAWA¹⁾, Chikako NAKAJIMA¹⁾, Shigenao MIMURA¹⁾, Hodaka TAKEUCHI¹⁾, Yoshihiro KUROSAWA¹⁾

IgA vasculitis is a common disease in childhood, but its diagnosis is not easy without typical skin lesions. This paper reports two such cases of IgA vasculitis that presented with abdominal symptoms only.
Case 1 was a 5-year-old girl admitted to this hospital because of severe abdominal pain and vomiting. Her blood examination revealed leucocytosis, elevated C-reactive protein(CRP) and D-dimer, and hypoproteinemia and low factor XIII. With the finding of intestinal edema, IgA vasculitis was suspected. Therefore, intravenous prednisolone, albumin and factor XIII were started. However, her abdominal symptoms did not improve, and she was transferred to a higher medical institution. The diagnosis of IgA vasculitis was supported by an upper gastrointestinal endoscopy.
Case 2 was a 3-year-old girl admitted to this hospital with abdominal pain, vomiting and black stools. Her clinical examination showed almost the same results as Case 1, and her illness was diagnosed as IgA vasculitis. Rapid improvement of clinical symptoms was recognized soon after starting intravenous administration of prednisolone and factor XIII. No skin lesions or joint pains were observed in these two cases.
The diagnosis of IgA vasculitis should not be excluded just because there is an absence of skin lesions.

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1) Devision of pediatrics, Ageo central general hospital

Key words	IgA vasculitis, abdominal symptoms, purpura, D-dimer
Received	December 22, 2020
Accepted	March 24, 2021

33 (2)：133─141,2021