HemoChat

Evidence-Based AI Medical Search

← Back to guidelines
Cardiology344 papers

Colitis

Last edited: 4/14/2026

Overview

IgA vasculitis (formerly Henoch-Schönlein purpura) is a systemic, immune complex-mediated, small-vessel vasculitis characterized by purpura, arthritis, abdominal pain, and often renal involvement. It predominantly affects children but can occur in adults 11.

Diagnosis

  • Key Diagnostic Criteria: Nonthrombocytopenic palpable purpura, abdominal pain, arthritis, and renal involvement 11.
  • Recommended Tests: Urinalysis, renal biopsy if indicated, and exclusion of other causes of purpura 11.
  • Classification Criteria: EULAR/PRINTO/PRES criteria show higher diagnostic sensitivity compared to older criteria 115.
  • Imaging/Endoscopy: Not routinely required unless specific organ involvement is suspected 11.

    • Management

  • First-Line Treatments: Corticosteroids for severe manifestations; no specific dose mentioned 11.
  • Adjunctive Treatments: Rituximab shows potential in stabilizing renal function in IgA vasculitis nephritis, though efficacy data is limited 3.
  • Antibiotics: Avoid unnecessary use due to risk of pseudomembranous colitis 4.
  • Immune Checkpoint Inhibitors: Monitor for colitis as a potential adverse effect 13.
  • Vitamin D Analogs: Experimental use of cholecalciterol cholesterol emulsion shows promise in ameliorating experimental colitis 16.

    • Special Populations

  • Pediatrics: Most common in children; management guidelines exist but vary 814.
  • Adults: Rare but recognized; EULAR/PRINTO/PRES criteria applicable with caution 15.
  • Comorbidities: No specific recommendations provided in abstracts; individualized care advised 11.

    • Key Recommendations

  • Use EULAR/PRINTO/PRES classification criteria for diagnosing IgA vasculitis in adults and children 115 (Evidence: Moderate).
  • Corticosteroids may be considered for severe manifestations of IgA vasculitis 11 (Evidence: Expert opinion).
  • Monitor patients on immune checkpoint inhibitors for potential colitis development 13 (Evidence: Moderate).
  • Avoid unnecessary antibiotic use to prevent pseudomembranous colitis 4 (Evidence: Moderate).
  • Consider rituximab in refractory cases of IgA vasculitis nephritis, though evidence is emerging 3 (Evidence: Weak).

    • References

    1 Bayindir Y, Grayson PC, Gribbons KB, Demir S, Audemard-Verger A, Ponte C et al.. Performance in adults of the EULAR/PRINTO/PRES (Ankara 2008) classification criteria for IgA vasculitis. RMD open 2025. link 2 An J, Wu K, Wu T, Xu P, Yang C, Fan Y et al.. Assessing the association between drug use and ischaemic colitis: a retrospective pharmacovigilance study using FDA Adverse Event data. BMJ open 2025. link 3 Xiong Y, Cuevas S, Xu G, Zou H. The efficacy of rituximab in the treatment of IgA vasculitis nephritis. Clinical and experimental medicine 2024. link 4 Chen J, Yu W, Zhang W, Sun C, Zhang W. Antibiotics-associated pseudomembranous colitis: a disproportionality analysis of the US food and drug administration adverse event reporting system (FAERS) database. Expert opinion on drug safety 2024. link 5 Honap S, Anderson S. Amoebic colitis masquerading as inflammatory bowel disease for a decade. The New Zealand medical journal 2023. link 6 Stampa Ferro J, Fernández González B, Arzallus Marco T, Izagirre Arostegi A, Azcue Prieto B, Cavero Barreras L et al.. IgA vasculitis (Henoch- Schönlein purpura) with gastrointestinal involvement. Revista espanola de enfermedades digestivas 2023. link 7 Messova A, Pivina L, Muzdubayeva Z, Sanbayev D, Urazalina Z, Adams A. COVID-19 and New Onset IgA Vasculitis: A Systematic Review of Case Reports. Journal of emergency nursing 2022. link 8 Kallash M, Vogt BA, Zeid A, Khin E, Najjar M, Aldughiem A et al.. The scope of treatment of pediatric IgA vasculitis nephritis and its outcome: a Pediatric Nephrology Research Consortium study. Pediatric nephrology (Berlin, Germany) 2022. link 9 Williams CEC, Toner A, Wright RD, Oni L. A systematic review of urine biomarkers in children with IgA vasculitis nephritis. Pediatric nephrology (Berlin, Germany) 2021. link 10 Buscatti IM, Simon JR, Viana VSL, Arabi TMA, Trindade VC, Maia ACC et al.. Intermittent abdominal pain in IgA vasculitis. Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo 2021. link 11 Reamy BV, Servey JT, Williams PM. Henoch-Schönlein Purpura (IgA Vasculitis): Rapid Evidence Review. American family physician 2020. link 12 Burns EM, Poulton T, Deputy M, Pinkney T, Guy R. An audit of process and outcome for emergency colectomy in England and Wales. Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland 2020. link 13 Hu Y, Gong J, Zhang L, Li X, Li X, Zhao B et al.. Colitis following the use of immune checkpoint inhibitors: A real-world analysis of spontaneous reports submitted to the FDA adverse event reporting system. International immunopharmacology 2020. link 14 Ozen S, Marks SD, Brogan P, Groot N, de Graeff N, Avcin T et al.. European consensus-based recommendations for diagnosis and treatment of immunoglobulin A vasculitis-the SHARE initiative. Rheumatology (Oxford, England) 2019. link 15 Hočevar A, Rotar Z, Jurčić V, Pižem J, Čučnik S, Vizjak A et al.. IgA vasculitis in adults: the performance of the EULAR/PRINTO/PRES classification criteria in adults. Arthritis research & therapy 2016. link 16 Xiong Y, Lou Y, Su H, Fu Y, Kong J. Cholecalciterol cholesterol emulsion ameliorates experimental colitis via down-regulating the pyroptosis signaling pathway. Experimental and molecular pathology 2016. link 17 Moszkowicz D, Trésallet C, Mariani A, Lefevre JH, Godiris-Petit G, Noullet S et al.. Ischaemic colitis: indications, extent, and results of standardized emergency surgery. Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 2014. link 18 van Rijn AF, Fockens P, Siersema PD, Oldenburg B. Adherence to surveillance guidelines for dysplasia and colorectal carcinoma in ulcerative and Crohn's colitis patients in the Netherlands. World journal of gastroenterology 2009. link 19 Kern JS, Herz C, Haan E, Moore D, Nottelmann S, von Lilien T et al.. Chronic colitis due to an epithelial barrier defect: the role of kindlin-1 isoforms. The Journal of pathology 2007. link 20 Holma R, Salmenperä P, Virtanen I, Vapaatalo H, Korpela R. Prophylactic potential of montelukast against mild colitis induced by dextran sulphate sodium in rats. Journal of physiology and pharmacology : an official journal of the Polish Physiological Society 2007. link 21 Gionchetti P, Lammers KM, Rizzello F, Campieri M. Probiotics and barrier function in colitis. Gut 2005. link 22 Layton D, Heeley E, Shakir SA. Identification and evaluation of a possible signal of exacerbation of colitis during rofecoxib treatment, using Prescription-Event Monitoring data. Journal of clinical pharmacy and therapeutics 2004. link 23 Lindström E, Norén B. Air enema revisited in assessment of colitis. Acta radiologica (Stockholm, Sweden : 1987) 1992. link 24 Labrune P, Huguet P, Alagille D, Odievre M. Familial cutaneous photosensitivity and colitis with lethal outcome. Journal of medical genetics 1991. link 25 White RF, Major GA. Gold colitis. The Medical journal of Australia 1983. link 26 Shein R, Gelb A. Colitis due to Dientamoeba fragilis. The American journal of gastroenterology 1983. link 27 Reichelderfer M, Morrissey JF. Colonoscopy in radiation colitis. Gastrointestinal endoscopy 1980. link73265-0) 28 Causey JQ. Granulomatous colitis and ileitis complicating jejunoileal bypass. Archives of internal medicine 1978. link 29 Tures JF, Townsend WF, Rose HD. Cephalosporin-associated pseudomembranous colitis. JAMA 1976. link

    Original source

    1. [1]
      Performance in adults of the EULAR/PRINTO/PRES (Ankara 2008) classification criteria for IgA vasculitis. — Bayindir Y, Grayson PC, Gribbons KB, Demir S, Audemard-Verger A, Ponte C et al. RMD open (2025)
    2. [2]
      Assessing the association between drug use and ischaemic colitis: a retrospective pharmacovigilance study using FDA Adverse Event data. — An J, Wu K, Wu T, Xu P, Yang C, Fan Y et al. BMJ open (2025)
    3. [3]
      The efficacy of rituximab in the treatment of IgA vasculitis nephritis. — Xiong Y, Cuevas S, Xu G, Zou H Clinical and experimental medicine (2024)
    4. [4]
      Antibiotics-associated pseudomembranous colitis: a disproportionality analysis of the US food and drug administration adverse event reporting system (FAERS) database. — Chen J, Yu W, Zhang W, Sun C, Zhang W Expert opinion on drug safety (2024)
    5. [5]
      Amoebic colitis masquerading as inflammatory bowel disease for a decade. — Honap S, Anderson S The New Zealand medical journal (2023)
    6. [6]
      IgA vasculitis (Henoch- Schönlein purpura) with gastrointestinal involvement. — Stampa Ferro J, Fernández González B, Arzallus Marco T, Izagirre Arostegi A, Azcue Prieto B, Cavero Barreras L et al. Revista espanola de enfermedades digestivas (2023)
    7. [7]
      COVID-19 and New Onset IgA Vasculitis: A Systematic Review of Case Reports. — Messova A, Pivina L, Muzdubayeva Z, Sanbayev D, Urazalina Z, Adams A Journal of emergency nursing (2022)
    8. [8]
      The scope of treatment of pediatric IgA vasculitis nephritis and its outcome: a Pediatric Nephrology Research Consortium study. — Kallash M, Vogt BA, Zeid A, Khin E, Najjar M, Aldughiem A et al. Pediatric nephrology (Berlin, Germany) (2022)
    9. [9]
      A systematic review of urine biomarkers in children with IgA vasculitis nephritis. — Williams CEC, Toner A, Wright RD, Oni L Pediatric nephrology (Berlin, Germany) (2021)
    10. [10]
      Intermittent abdominal pain in IgA vasculitis. — Buscatti IM, Simon JR, Viana VSL, Arabi TMA, Trindade VC, Maia ACC et al. Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo (2021)
    11. [11]
      Henoch-Schönlein Purpura (IgA Vasculitis): Rapid Evidence Review. — Reamy BV, Servey JT, Williams PM American family physician (2020)
    12. [12]
      An audit of process and outcome for emergency colectomy in England and Wales. — Burns EM, Poulton T, Deputy M, Pinkney T, Guy R Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland (2020)
    13. [13]
      Colitis following the use of immune checkpoint inhibitors: A real-world analysis of spontaneous reports submitted to the FDA adverse event reporting system. — Hu Y, Gong J, Zhang L, Li X, Li X, Zhao B et al. International immunopharmacology (2020)
    14. [14]
      European consensus-based recommendations for diagnosis and treatment of immunoglobulin A vasculitis-the SHARE initiative. — Ozen S, Marks SD, Brogan P, Groot N, de Graeff N, Avcin T et al. Rheumatology (Oxford, England) (2019)
    15. [15]
      IgA vasculitis in adults: the performance of the EULAR/PRINTO/PRES classification criteria in adults. — Hočevar A, Rotar Z, Jurčić V, Pižem J, Čučnik S, Vizjak A et al. Arthritis research & therapy (2016)
    16. [16]
      Cholecalciterol cholesterol emulsion ameliorates experimental colitis via down-regulating the pyroptosis signaling pathway. — Xiong Y, Lou Y, Su H, Fu Y, Kong J Experimental and molecular pathology (2016)
    17. [17]
      Ischaemic colitis: indications, extent, and results of standardized emergency surgery. — Moszkowicz D, Trésallet C, Mariani A, Lefevre JH, Godiris-Petit G, Noullet S et al. Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver (2014)
    18. [18]
      Adherence to surveillance guidelines for dysplasia and colorectal carcinoma in ulcerative and Crohn's colitis patients in the Netherlands. — van Rijn AF, Fockens P, Siersema PD, Oldenburg B World journal of gastroenterology (2009)
    19. [19]
      Chronic colitis due to an epithelial barrier defect: the role of kindlin-1 isoforms. — Kern JS, Herz C, Haan E, Moore D, Nottelmann S, von Lilien T et al. The Journal of pathology (2007)
    20. [20]
      Prophylactic potential of montelukast against mild colitis induced by dextran sulphate sodium in rats. — Holma R, Salmenperä P, Virtanen I, Vapaatalo H, Korpela R Journal of physiology and pharmacology : an official journal of the Polish Physiological Society (2007)
    21. [21]
      Probiotics and barrier function in colitis. — Gionchetti P, Lammers KM, Rizzello F, Campieri M Gut (2005)
    22. [22]
      Identification and evaluation of a possible signal of exacerbation of colitis during rofecoxib treatment, using Prescription-Event Monitoring data. — Layton D, Heeley E, Shakir SA Journal of clinical pharmacy and therapeutics (2004)
    23. [23]
      Air enema revisited in assessment of colitis. — Lindström E, Norén B Acta radiologica (Stockholm, Sweden : 1987) (1992)
    24. [24]
      Familial cutaneous photosensitivity and colitis with lethal outcome. — Labrune P, Huguet P, Alagille D, Odievre M Journal of medical genetics (1991)
    25. [25]
      Gold colitis. — White RF, Major GA The Medical journal of Australia (1983)
    26. [26]
      Colitis due to Dientamoeba fragilis. — Shein R, Gelb A The American journal of gastroenterology (1983)
    27. [27]
      Colonoscopy in radiation colitis. — Reichelderfer M, Morrissey JF Gastrointestinal endoscopy (1980)
    28. [28]
      Granulomatous colitis and ileitis complicating jejunoileal bypass. — Causey JQ Archives of internal medicine (1978)
    29. [29]
      Cephalosporin-associated pseudomembranous colitis. — Tures JF, Townsend WF, Rose HD JAMA (1976)
    Share:TwitterRedditLinkedIn

    HemoChat

    by SPINAI

    Evidence-based clinical decision support powered by SNOMED-CT, Neo4j GraphRAG, and NASS/AO/NICE guidelines.

    ⚕ For clinical reference only. Not a substitute for professional judgment.

    © 2026 HemoChat. All rights reserved.
    Research·Pricing·Privacy & Terms·Refund·SNOMED-CT · NASS · AO Spine · NICE · GraphRAG