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CASE REPORT   

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2021 May;180(5):235-42

DOI: 10.23736/S0393-3660.19.04211-6

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Immunoglobulin A vasculitis: challenging renal implications of adult onset

Cristina P. CORREIA 1 , António MARTINS 1, José G. FREITAS 1, Verónica GUIOMAR 1, Jorge OLIVEIRA 1, Catarina MENG 2

1 Department of Internal Medicine, São João Hospital, Porto, Portugal; 2 Department of Nephrology, São João Hospital, Porto, Portugal



Immunoglobulin A vasculitis, a small vessel vasculitis mediated by IgA-immune complex deposition, represents a multisystem disease with an unclear pathogenesis and potential renal, cardiac, pulmonary, gastrointestinal and neurological complications. We describe a case of a 53-year-old male presented with fever and sore throat for 5 days associated with a palpable purpuric eruption, arthralgia and swelling of wrist and ankle. Punch biopsy of involved skin demonstrated leukocytoclastic vasculitis, accompanied by deposition of IgA on vascular walls on direct immunofluorescent staining. During hospitalization, he started abdominal pain and three weeks later he remained with proteinuria and a decline in renal function was detected. The purpose of this case report is to emphasize the diagnostic approach demanded, as well as the course, complications and management of HSP. The adult set is rare and requires a complex work up including evaluation for malignancy. Kidney involvement, present in half of patients may appear later, and can became severe, presenting as isolated hematuria or proteinuria, nephrotic and nephritic syndrome, and even renal failure. We emphasize the importance of treatment and follow-up based on recent studies reported in literature.


KEY WORDS: Schoenlein-Henoch purpura; Cutaneous leukocytoclastic vasculitis; Immunoglobulin A; Purpura; IgA glomerulonephritis

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