Article in Japanese

Two cases of IgA vasculitis triggered by COVID-19

Shoko Momose^1）, Hiroshi Kubo^1）, Erika Takigami^1）, Taeko Saito^1）, Shota Fukuhara^1）, Kimito Todo^1）, Shigemi Morioka^1）, Naho Kobayashi^1）, Noriko Fujii^1）, Gen Kano^1）

IgA vasculitis, also known as small vessel vasculitis, is often preceded by upper respiratory tract inflammation one to two weeks before onset. It has been reported that IgA vasculitis is also triggered following novel coronavirus infection (COVID-19), but its pathogenesis, clinical features, and prognosis remain unclear. In addition, cases of early- onset, within one week after COVID-19, have been reported. Herein, two cases of IgA vasculitis associated with COVID-19 have been reported with different timing of onset. Case 1 is a 4-year-old boy. The initial symptoms were fever and abdominal pain. Five days later, purpura was observed on both lower legs, and IgA vasculitis was diagnosed. Based on polymerase chain reaction (PCR) test results, it was presumed that the disease was triggered directly by COVID-19. The patient was treated with intravenous prednisolone (PSL). Case 2 is a 6-year-old boy. The first symptom was purpura, followed by abdominal pain and arthralgia two days later, and a diagnosis of IgA vasculitis was made. Based on the course of the disease and PCR test results, it was thought that COVID-19 triggered the disease indirectly about two weeks previously. The abdominal pain was prolonged, but improved gradually after PSL administration. Both patients had no nephritis six months after onset and are now in remission without needing treatment. Clinicians should be aware that IgA vasculitis may develop in patients with COVID-19, even in early stages of the disease.

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1）Department of Pediatrics, Kyoto Second Red Cross Hospital Kyoto Japan

Key words	IgA vasculitis, SARS-CoV-2 infection, COVID-19
Received	April 21, 2024
Accepted	September 7, 2024

36 (4)：345─351,2024