Imaging and laboratory findings of adult abdominal IgAV stratified by the onset sequence of cutaneous and gastrointestinal symptoms: a retrospective case series
Year: 2026
Type: article
Abstract: Objectives To describe Computed Tomography (CT) and laboratory findings in adult cases of abdominal immunoglobulin A vasculitis (IgAV), comparing patients who experienced cutaneous purpura before versus after gastrointestinal (GI) symptoms. Methods We retrospectively studied eight adults (median age, 66 years; range, 18–83; 7 males) diagnosed with abdominal IgAV at our hospital (2020–2025). All underwent abdominal CT and were grouped as rash-first (n=5) or abdominal-first (n=3). Results All eight patients showed bowel wall thickening; seven had the target sign, and six had peritoneal effusion. The ileum (6/8) and jejunum (5/8) were most frequently involved. C-reactive protein (CRP) was elevated in seven patients; the neutrophil-to-lymphocyte ratio (NLR) and D-dimer were elevated in all eight. All patients’ abdominal symptoms improved before discharge; purpura improved or resolved in seven, and the subsequent purpura in Case 3 resolved after outside-hospital treatment. The abdominal-first group had a higher median D-dimer (7.11 vs. 4.96 µ g/mL; range, 4.70–22.39 vs. 2.50–8.34), and segmental involvement was seen in 2/3 abdominal-first versus 1/5 rash-first patients. Conclusion Wall thickening and the target sign were the primary CT findings, predominantly in the jejunoileal region. A descriptive trend toward segmental involvement was observed in patients with abdominal pain preceding purpura (2/3 vs. 1/5), whereas elevated D-dimer and the target sign were near-universal regardless of onset sequence and thus not subgroup-specific. These combined CT and laboratory features may suggest abdominal IgAV in acute abdominal pain, especially when purpura appears subsequently or concurrently. Larger prospective studies are needed to validate these findings.
Source: Frontiers in Immunology
Institution: Zunyi Medical University
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7225828221