Fever and Abdominal Purpura Linked to IgAV Recurrence in Adults

Key Takeaways

• Fever, abdominal purpura, and articular involvement were associated with increased relapse risk in adult IgAV.

• Post-bacterial etiology and systemic corticosteroid therapy were linked to lower recurrence rates.

• Colchicine did not significantly reduce relapse risk after adjustment for treatment bias.

Systemic corticosteroids and post-bacterial etiology may protect against recurrence or relapse in adult immunoglobulin A vasculitis (IgAV), a new study suggests.

Investigators for the retrospective cohort study included 229 adult patients in the analysis, with time to recurrence or relapse as the primary study outcome. Baseline clinical features were noted as significant predictors. Fever at diagnosis was associated with more than a threefold increased risk of recurrence or relapse (HR = 3.54; 95% CI, 1.19 to 10.5; P = 0.023). Abdominal purpura (HR = 2.03; 95% CI, 1.16 to 3.58; P = 0.014) and articular involvement (HR = 2.29; 95% CI, 1.25 to 4.20; P = 0.0074) were also independently associated with higher relapse risk.

Post-bacterial etiology was linked with a lower risk of recurrence (HR = 0.26; 95% CI, 0.07 to 0.93; P = 0.039). Systemic corticosteroid use was also protective (HR = 0.30; 95% CI, 0.12 to 0.75; P = 0.0098). These findings persisted after adjustment, with corticosteroids remaining associated with reduced relapse risk, while colchicine showed no benefit.

"Systemic corticosteroid administration and post-bacterial etiology appear to protect against recurrence/relapse in adult IgAV," the authors wrote. "Conversely, fever at diagnosis, abdominal purpura, and articular involvement may be associated with an increased risk."

Source: Lutz W, et al. JAAD. 2026. doi:10.1016/j.jaad.2025.10.009