Relief of Suspected IgA Vasculitis-Associated Enterocolitis Manifested as Severe Diarrhea and Hypoalbuminemia Treated With Glucocorticoid Therapy and Administration of Fibrogammin® (Purified Coagulation Factor XIII Concentrate): A Case Report

A 62-year-old female was admitted to our hospital with abdominal pain, diarrhea, and bloody stool. She suffered from severe diarrhea 30 times per day and consequently got hypoalbuminemia and hyponatremia. Esophagogastroduodenoscopy and total colonoscopy showed diffuse erosion of the duodenum, terminal ileum, and colorectum. Her endoscopic findings were similar to the former case reports of immunoglobulin A (IgA) vasculitis-associated enterocolitis. Further investigation of biopsy demonstrated that IgA-positive lymphocytes invaded the perivascular of the submucosal layer. However, we did not find IgA deposition in the capillary wall, and no granuloma, basal plasma cytosis, or crypt abscess was detected. Although a definite diagnosis could not be established, we considered the possibility of refractory IgA vasculitis-associated enterocolitis and initiated glucocorticoid therapy and administration of Fibrogammin® (purified coagulation factor XIII concentrate). The patient's diarrhea improved within one and a half months after admission.