Imaging and laboratory findings of adult abdominal IgAV stratified by the onset sequence of cutaneous and gastrointestinal symptoms: a retrospective case series
Abstract
ObjectivesTo 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.MethodsWe 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).ResultsAll 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 µg/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.ConclusionWall 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.
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BibTeX
@article{zhang2026imaging,
title = {{Imaging and laboratory findings of adult abdominal IgAV stratified by the onset sequence of cutaneous and gastrointestinal symptoms: a retrospective case series}},
author = {Dewei Zhang and Shihan Shi and Changhao Sun and Yang Wei and Jin Wei and Jie Xie and Si Gui and Xuejian Wang and Liming Zhou and Yan Zhang},
journal = {Frontiers in Immunology},
year = {2026},
month = nov,
doi = {10.3389/fimmu.2026.1960721},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1960721},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Imaging and laboratory findings of adult abdominal IgAV stratified by the onset sequence of cutaneous and gastrointestinal symptoms: a retrospective case series
AU - Dewei Zhang
AU - Shihan Shi
AU - Changhao Sun
AU - Yang Wei
AU - Jin Wei
AU - Jie Xie
AU - Si Gui
AU - Xuejian Wang
AU - Liming Zhou
AU - Yan Zhang
PY - 2026
DA - 2026/11/11
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1960721
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1960721
AB - ObjectivesTo 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.MethodsWe 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).ResultsAll 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 µg/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.ConclusionWall 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.
SN - 1664-3224
ER -