A70 SEVERE ENTERITIS AND IGA VASCULITIS IN A PEDIATRIC PATIENT WITH ULCERATIVE COLITIS ON VEDOLIZUMAB

Abstract

Abstract Background Pediatric Ulcerative Colitis (UC) is often unsatisfactorily controlled using ‘conventional’ therapies, thus there has been increasing use of biologic therapies and small molecules to try and improve rates of clinical remission and mucosal healing. Consequently, pediatric gastroenterologists and generalists should be aware of the complications and side effects of these newer molecules. Vedolizumab (VDZ) is a fully humanised anti-integrin therapy that is thought to limit systemic side effects given its gut-specific mechanism. Aims Here we report the unique case of a 14-year-old male with UC on vedolizumab presenting with severe abdominal pain, GI bleeding, markedly elevated inflammatory markers and subsequent purpura. Methods N/A Results A diagnosis of IgA vasculitis (IgAV) was made after extensive imaging, endoscopy and subspecialty consultation. Clinical course was complicated but ultimately responded to high dose steroid treatment without cessation of VDZ. Conclusions This case illustrates a potentially independent pathway behind IgAV in a patient on a gut-selective therapy with UC. This is the first pediatric case of vasculitis in a patient with UC on VDZ. Funding Agencies None