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E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
We report the diagnosis and treatment of a 22-year-old woman who visited our hospital complaining of facial erythema, abdominal discomfort, and subsequent vomiting.
On admission, miliary purpura was noted on the limbs and face, along with polyarthralgia. Endoscopy revealed erosions with redness in the duodenum, and a biopsy was performed. A diagnosis of venous vasculitis was made, with hemorrhage and fibrin deposition in the submucosa and significant neutrophil infiltration. A skin biopsy revealed leukocytoclastic vasculitis with fibrin deposition throughout the dermis. Treatment with 1 mg/kg prednisolone was initiated, but the condition was refractory. One month after the onset of symptoms, newly proteinuria (1 g/g Cre) and urinary occult blood were noted, and a renal biopsy was performed. Glomerular lesions with IgA deposition, fibrin deposition and cellular crescent formation were observed, leading to a diagnosis of severe IgA vasculitis.
Steroid pulse therapy was initiated in combination with azathioprine. Thereafter, azathioprine was replaced with mycophenolate mofetil, and colchicine was added to the regimen. Five months after the onset of symptoms, severe lower abdominal pain suddenly appeared. A diagnosis of ileocecal perforation was made, and an emergency laparoscopic ileocecal resection was performed. Pathological examination revealed venous vasculitis in the ulcer at the perforation site, consistent with gastrointestinal lesions of intestinal Behçet's disease. Although no oral aphthous lesions or uveitis were present, the patient received infliximab therapy as described for Behçet's disease. Urinary protein and occult blood rapidly disappeared, and abdominal pain also improved. The patient's progress is favorable with continued infliximab administration.
We report a case of IgA vasculitis presenting with steroid-resistant gastrointestinal lesions. Venous vasculitis similar to Behçet's disease was diagnosed as the primary pathology, and TNF therapy, which is effective for Behçet's disease, was effective for this patient. Although IgA vasculitis is described as inflammation of small vessels in the skin, kidneys, and intestines, no detailed explanation was given as to which part of the blood vessels (arterial or venous) it corresponds to. Our findings suggest that venous vasculitis plays a key role in steroid resistance. Thus, considering IgA vasculitis as an autoinflammatory disease, anti-cytokine therapies—particularly TNF inhibitors—may offer a viable treatment option for steroid-resistant IgA vasculitis.
