Can the affected intestinal segment visualized on abdominal ultrasound predict gastrointestinal tract bleeding in immunoglobulin A vasculitis?

Objective: To evaluate immunoglobulin A vasculitis (IgAV) patients with gastrointestinal (GI) tract involvement and to reveal the relationship between the location and extent of the affected intestinal segment detected on the initial abdominal ultrasound (US) and GI tract bleeding.

Methods: This medical record review study was conducted on 117 IgAV patients with GI tract involvement between January 2016- June 2023. Patients were divided into two groups as those with (n=28) and without (n=89) GI tract bleeding. Predictors of GI tract bleeding were investigated by comparing demographic, clinical characteristics and laboratory findings.

Results: Gender, age at diagnosis, symptoms at admission, rash distribution, GI tract complaints, and the elapsed time until the development of GI tract symptoms were similar in both groups. There was no difference between small intestinal, large intestinal or small+large intestinal involvement (p=0.89). The ileum was the most commonly affected intestinal segment in patients with and without GI tract bleeding (p=0.37). Jejunal wall thickening (p=0.04) and the number of affected intestinal segments (p=0.008) were higher in patients with GI tract bleeding.

Conclusion: In IgAV patients, jejunum involvement and affected multiple intestinal segments shown by abdominal US are associated with GI tract bleeding.