The University of Toledo Translation Journal of Medical Sciences 
Internal Medicine Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e1 

Imipramine, Ulcerative Colitis and Linear 
Iga Bullous Dermatosis - A Curious Triad 
Kylie Rostad1*, Victoria Starnes1, Hira Pervez, MD1, Joel Kammeyer MD, MPH1 

1Division of Infectious Diseases , Department of Medicine, The University of 
Toledo, Toledo, OH 43614 

*Corresponding author: kylie.rostad@rockets.utoledo.edu

Published: 05 May 2023 

Introduction: Linear IgA bullous dermatosis (LABD) is a rare autoimmune subepithelial 
vesiculobullous phenomenon caused by IgA antibodies against skin or mucosal basement membrane 
antigens. Though most commonly idiopathic, known causes include medications and gastrointestinal 
diseases. We present a case of LABD associated with ulcerative colitis which was temporally associated 
with initiation of imipramine.    

Case: 18 year old male presented to the ED for evaluation of a painful, blistering rash that began on his 
neck and spread over 24 hours. Patient had been started on Imipramine 2 weeks prior for nocturnal 
enuresis. On examination, the patient had diffuse annular arrangement of tender vesicles and bullae 
which progressively worsened to fluid-filled blisters on his extremities. Punch biopsies showed 
subepidermal blistering dermatosis with papillary dermal neutrophils compatible with dermatitis 
herpetiformis. The patient began to experience bloody stools, and colonoscopy revealed active ulcerative 
colitis. Subsequent immunofluorescence studies on the skin biopsy showed continuous strong IgA linear 
deposition along the basement membrane consistent with linear IgA bullous dermatosis.    

Discussion: In this patient, the presentation of LABD could be a drug-induced dermatitis or an 
associated finding of ulcerative colitis; however, both are rare. It has been theorized that the 
pathogenesis of rheumatological conditions involves exposure to a trigger in a susceptible individual. 
The temporal association of the imipramine initiation suggests that the medication may have acted as the 
trigger for LABD development during this initial flare of UC. We therefore propose imipramine as a 
potential causative agent for the development of LABD in patients with IBD. 

https://dx.doi.org/10.46570/utjms.vol11-2023-714 

https://dx.doi.org/10.46570/utjms.vol11-2023-714
mailto:kylie.rostad@rockets.utoledo.edu