A Familiar Face in the Treatment of Immunoglobulin A Vasculitis: Colchicine

Year 2024, Articles Online First, 1 - 5

Merve Cansu Polat , Mehveş Işıklar Ekici , Melike Mehveş Kaplan , Elif Çelikel , Zahide Ekici Tekin , Vildan Güngörer , Cüneyt Karagöl , Nimet Öner , Didem Öztürk , Emine Özçelik , Yasemin Uğur Es , Sultan Nilay Yoğun , Banu Acar

https://doi.org/10.12956/tchd.1514723

Abstract

Objective: The aim of the this study was to evaluate immunoglobulin A vasculitis (IgAV) patients on colchicine therapy and determine the causative factors leading to the initiation and maintenance of colchicine.

Material and Methods: This retrospective study was conducted receiving IgAV patients on colchicine at our clinic between January 2013 and June 2023. Demographic, clinical, and laboratory data of IgAV patients were obtained from their electronic medical records.

Results: A total of 33 IgAV patients receiving colchicine, 20 (60.6%) males and 13 (39.4%) females, were included in the study. The mean age at diagnosis of IgAV was 111.6±45.5 months. Colchicine was initiated in 13 (39.4%) patients with persistent rash, 8 (24.2%) with severe gastrointestinal tract involvement, seven (21.2%) with generalized/severe rash, and five (15.2%) with recurrent IgAV. The median elapsed time to colchicine initiation was 30 (10.5-60) days. The median duration of colchicine usage was ten (IQR, 6-54) months.
Colchicine treatment was discontinued in 14 patients after a median 6.5 (IQR, 3-11.2) months. At the last visit, 13 (39.4%) patients were receiving colchicine for familial Mediterranean fever (FMF), four (12.1%) for recurrent IgAV, and two (6.1%) for persistent rash.

Conclusion: Colchicine should be kept in mind especially in the presence of severe, persistent or recurrent rash. Early initiation of colchicine treatment should be considered in IgAV patients with severe GI tract disease, especially in countries where FMF is common.

Keywords

Colchicine, Immunoglobulin A vasculitis, Leukocytoclastic vasculitis, Recurrence

Ethical Statement

Colchicine treatment is beneficial in some cases, as demonstrated by the long-term follow-up of our study, including the period after other immunosuppressives were discontinued.

İmmünglobulin A Vaskülitinin Tedavisinde Tanıdık Bir Yüz: Kolşisin

Abstract

Amaç: Bu çalışmanın amacı kolçisin tedavisi alan immünglobulin A vasküliti (IgAV) hastalarını değerlendirmek ve kolşisin başlanması ve devam edilmesine neden olan etkenleri belirlemektir.

Gereç ve Yöntemler: Bu retrospektif çalışma, Ocak 2013 ile Haziran 2023 tarihleri arasında kliniğimizde takip edilen ve kolşisin kullanan IgAV hastaları üzerinde yapıldı. IgAV hastalarının demografik, klinik ve laboratuvar verileri elektronik tıbbi kayıtlarından elde edildi.

Bulgular: Kolşisin alan 20’si (%60.6) erkek ve 13’ü (%39.4) kadın olmak üzere toplam 33 IgAV hastası çalışmaya dahil edildi. Ortalama IgAV tanı yaşı 111.63±45.52 aydı. Kolşisin 13 (%39.4) hastada inatçı döküntü, sekiz (%24.2) hastada ciddi GI sistem tutulumu, yedi (%21.2) hastada jeneralize/şiddetli döküntü ve 5 (%15.2) hastada tekrarlayan IgAV nedeni ile başlandı. Kolşisin başlanmasına kadar geçen ortanca süre 30 (10.5-60) gündü. Ortanca kolşisin kullanım süresi on (IQR,6-54) aydı. Kolşisin tedavisi 14 hastada medyan 6.5 (IQR, 3-11.2) ay sonra kesildi. Son vizitte, 13 hasta (%39.4) ailesel Akdeniz ateşi (AAA), dört hasta (%12.1) tekrarlayan IgAV ve iki hasta (%6.1) inatçı döküntü nedeniyle kolşisin almaktaydı.

Sonuç: Kolşisin tedavisinin başlanması şiddetli, inatçı veya tekrarlayan döküntü varlığında akılda tutulmalıdır. Özellikle AAA’nın yaygın olduğu ülkelerde, ciddi GİS hastalığı olan IgAV hastalarında kolşisin tedavisinin erken başlanması düşünülmelidir.

Keywords

Kolşisin, İmmünoglobulin A vasküliti, Lökositoklastik vaskülit, Nüks

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