<Case Reports> Recurrent atypical cutaneous lesions of IgA vasculitis successfully treated with colchicine: a case report

[Abstract] Background: Corticosteroids have a common therapeutic use for recurrent, severe symptoms of Immunoglobulin A vasculitis (IgAV), but several adverse effects are associated with prolonged administration. Colchicine is mentioned as a therapeutic option for cutaneous vasculitis in adults, however only a few cases of colchicine use have been reported in children. Case presentation: A 10-year-old Japanese girl presented typical symptoms of IgAV, consisting of palpable purpura on legs, abdominal pain and knee arthritis. Prednisolone was administrated, but symptoms recurred as prednisone was gradually decreased. Combination with Fibrogammin was also initiated after confirming the decrease of factor XIII activity. As severe cutaneous findings, such as ecchymosis on the right shoulder, upper limbs and lower extremities with cyanotic appearance in right foot, recurred and exacerbated, colchicine was started. Colchicine was dosed up and remained unchanged for 2 months before it was gradually tapered, with gradual improvement of cutaneous manifestations and arthralgia. Colchicine was finally discontinued 5 months after initiation, and no recurrence or renal complication are observed till this date. Conclusions: We presented a case of IgAV that was effectively treated with colchicine for chronic and relapsing atypical cutaneous lesions and arthralgia. Our pathophysiological and preliminary clinical findings support the use and efficacy of colchicine in pediatric patients presenting with chronic and severe cutaneous lesions of IgAV. Further studies are needed in order to clarify the effectiveness and safety of colchicine.