Abstract: TH-PO0549
Crohn Disease Complicated by IgA Vasculitis-Associated Nephritis: Renal Outcomes After Ustekinumab-Maintained Intestinal Remission
Session Information
- Glomerular Diseases: IgAN, IgA Vasculitis, and More
October 22, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Qin, Yu, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- Tang, Juan, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- Li, Aimei, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
- Yi, Bin, Third Xiangya Hospital of Central South University, Changsha, Hunan, China
Introduction
Crohn’s disease is a chronic inflammatory bowel disease with various extraintestinal manifestations. Renal involvement is uncommon but may progress to crescentic glomerulonephritis. IgA vasculitis can affect the skin, joints, gastrointestinal tract, and kidneys, and its gastrointestinal symptoms may overlap with active Crohn’s disease, making diagnosis challenging.
Case Description
A 24-year-old Asian man was diagnosed with Crohn’s disease after presenting with altered bowel habits and undergoing intestinal biopsy. In August 2025, he was admitted with abdominal pain, hematochezia, and scattered purpura on the extremities. Intestinal pathology supported Crohn’s disease, and ustekinumab was initiated, leading to improvement in abdominal pain and skin lesions. Ustekinumab was continued every 8 weeks. Four months later, he developed proteinuria and elevated serum creatinine. Laboratory tests showed 24-hour urinary protein of 4,406 mg/24 h, serum creatinine of 187 μmol/L, and marked hematuria and proteinuria. Renal biopsy revealed mesangial proliferation, mesangial electron-dense deposits, and crescent formation, supporting a diagnosis of IgA vasculitis–associated nephritis. He was treated with methylprednisolone and tacrolimus, followed by maintenance therapy with ustekinumab, tacrolimus, and prednisone. Follow-up colonoscopy showed intestinal remission, and renal function and proteinuria improved, although long-term follow-up remains necessary.
Discussion
In patients with Crohn’s disease, purpura, hematuria, proteinuria, and renal dysfunction should raise suspicion for IgA vasculitis–associated nephritis or immune complex–mediated glomerulonephritis. Renal biopsy is essential for diagnosis and treatment guidance. Ustekinumab may maintain intestinal remission, but renal immune injury may still require glucocorticoids and immunosuppressants, with close monitoring of proteinuria, renal function, and drug levels.