抄録
A 30-year-old man with ulcerative colitis that had been in remission for 15 years developed intermittent abdominal pain and multiple episodes of diarrhea per day 1 day after receiving the second dose of the coronavirus disease 2019 (COVID-19) vaccine. Thirteen days after initial symptom onset, he was admitted to our hospital with the aforementioned symptoms along with slight fever, abnormal gait due to bilateral calf pain, and purpura in the bilateral lower legs, which had appeared 1 day previously. The results of clinical tests, including skin biopsy, suggested that the patient’s symptoms were due to immunoglobulin (Ig)A vasculitis. The purpura and calf pain resolved with rest and symptomatic treatment;however, intermittent fever (nocturnal body temperature ›39 °C) and firm bloodstained stools appeared 17 days after initial symptom onset. He was transferred to the gastroenterology department of another hospital 19 days after initial symptom onset and diagnosed with acute exacerbation of ulcerative colitis. Cases of IgA vasculitis and ulcerative colitis in patients with no history of recent tumor necrosis factor-α inhibitor use are rare. Although cases of IgA vasculitis after COVID-19 vaccination have been reported, this is the first case in which histological examination was performed.
