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CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(11): E1333-E1343
DOI: 10.1055/a-0977-2777
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

Gastrointestinal involvement in patients with vasculitis: IgA vasculitis and eosinophilic granulomatosis with polyangiitis

Keisuke Kawasaki
1   Division of Gastroenterology, Iwate Medical University, Morioka, Japan
,
Shotaro Nakamura
1   Division of Gastroenterology, Iwate Medical University, Morioka, Japan
,
Motohiro Esaki
2   Department of Endoscopic Diagnostics and Therapeutics, Saga University Hospital, Saga, Japan
3   Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
,
Koichi Kurahara
4   Division of Gastroenterology, Matsuyama Red Cross Hospital, Matsuyama, Japan
,
Makoto Eizuka
5   Department of Diagnostic Pathology, Iwate Medical University, Morioka, Japan
,
Yasuharu Okamoto
3   Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
,
Takashi Hirata
4   Division of Gastroenterology, Matsuyama Red Cross Hospital, Matsuyama, Japan
,
Minako Hirahashi
6   Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
,
Yumi Oshiro
7   Department of Pathology, Matsuyama Red Cross Hospital, Matsuyama, Japan
,
Shunichi Yanai
1   Division of Gastroenterology, Iwate Medical University, Morioka, Japan
,
Kunihiko Sato
1   Division of Gastroenterology, Iwate Medical University, Morioka, Japan
,
Yosuke Toya
1   Division of Gastroenterology, Iwate Medical University, Morioka, Japan
,
Makoto Maemondo
8   Division of Pulmonary Medicine, Allergy, and Rheumatology, Iwate Medical University, Morioka, Japan
,
Yasuo Terayama
9   Division of Neurology and Gerontology, Department of Internal Medicine, Iwate Medical University, Morioka, Japan
,
Tamotsu Sugai
5   Department of Diagnostic Pathology, Iwate Medical University, Morioka, Japan
,
Takayuki Matsumoto
1   Division of Gastroenterology, Iwate Medical University, Morioka, Japan
› Author Affiliations
Further Information

Publication History

submitted 26 February 2019

accepted after revision 29 May 2019

Publication Date:
22 October 2019 (online)

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Abstract

Background and study aims Among vasculitides, IgA vasculitis (IgAV) and eosinophilic granulomatosis with polyangiitis (EGPA) frequently damage the gastrointestinal tract. However, only a few studies have investigated the entire gastrointestinal tract in patients with IgAV or EGPA by endoscopy. The aim of this study was to clarify endoscopic characteristics of patients with IgAV and those with EGPA.

Patients and methods Clinicopathological and endoscopic findings were retrospectively compared between 33 patients with IgAV and 19 patients with EGPA.

Results Gastrointestinal involvement was observed in 33 patients with IgAV (100 %) and in 8 patients with EPGA (42 %; P = 0.0001). Duodenal involvement was more frequent in patients with IgAV (75.8 %) than in those with EGPA (21.1 %, P = 0.0002). Jejunoileal involvement was frequent in both groups (IgAV 94.4 %; EGPA 77.8 %). Gastric mucosal erythema was more frequent in patients with IgAV (18.2 %) than in those with EGPA (0 %, P = 0.0481). Duodenal mucosal erythema (IgAV 54.6 %; EGPA 21.1 %, P = 0.0227), ulcer (IgAV 33.3 %; EGPA 0 %, P = 0.0041), and hematoma-like protrusion (IgAV 21.1 %; EGPA 0 %, P = 0.039) were more frequently observed in patients with IgAV than in those with EGPA.

Conclusions Frequent duodenal involvement, gastric mucosal erythema, and duodenal lesions including erythema, ulcer, and hematoma-like protrusion are characteristic of patients with IgAV. Because jejunoileal involvement was frequent in both groups of patients, small-bowel endoscopies should be performed for diagnosis of small-bowel lesions in patients with IgAV and EGPA.

Comment to this article:

Endoscopy International Open – recently publishedEndoscopy 2019; 51(12): 1189-1189
DOI: 10.1055/a-1017-4270

 

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