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Low-dose corticosteroid with mizoribine might be an effective therapy for elderly-onset ISKDC grade VI IgA vasculitis

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Abstract

Both the diagnosis of elderly-onset IgA vasculitis (IgAV) and its prognosis can be difficult because of its rarity and the likely presence of comorbidities. Furthermore, the treatment of elderly-onset IgAV remains controversial: the ideal dosages of corticosteroid and/or immunosuppressants have not been determined. In the elderly, corticosteroid adverse effects can lead to severe outcomes, and a consensus regarding its benefit and risk balance has not been reached. We report a case of IgAV in an 89-year-old patient who was admitted to our hospital to investigate a 30-day history of palpable purpura and pitting edema on her leg. A renal biopsy showed membranoproliferative glomerulonephritis with IgA deposits (The International Study of Kidney Disease in Children (ISKDC) grade VI), which is a predictor of a poor prognosis; these findings led to early intervention with low-dose corticosteroid (15 mg/day) and mizoribine. As a result, a complete remission without obvious adverse effects was obtained. Early intervention with low-dose corticosteroid and mizoribine based on renal histopathology results might be an effective treatment for elderly-onset ISKDC grade VI IgAV.

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Authors and Affiliations

  1. Department of Nephrology, Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan

    Hikaru Sugimoto, Shiho Matsuno, Noriko Yamanaka, Wako Yumura, Mitsuyo Itabashi & Takashi Takei

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  1. Hikaru Sugimoto
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  2. Shiho Matsuno
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  3. Noriko Yamanaka
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  6. Takashi Takei
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Correspondence to Hikaru Sugimoto.

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Sugimoto, H., Matsuno, S., Yamanaka, N. et al. Low-dose corticosteroid with mizoribine might be an effective therapy for elderly-onset ISKDC grade VI IgA vasculitis. CEN Case Rep 10, 46–52 (2021). https://doi.org/10.1007/s13730-020-00513-6

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  • DOI: https://doi.org/10.1007/s13730-020-00513-6

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