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. 2019 Mar 25;6(4):001083.
doi: 10.12890/2019_001083. eCollection 2019.

Intra-Alveolar Haemorrhage Complicating IgA Vasculitis: A Case Report, Literature Review and Discussion of Treatment

Benjamin Savoye  1 , Gwenola Maigne  1 , Evangeline Pillebout  2 , Gaetane Planchard  3 , Maxime Faisant  3 , Achille Aouba  1   4 , Alexandra Audemard-Verger  1   4
Affiliations

Intra-Alveolar Haemorrhage Complicating IgA Vasculitis: A Case Report, Literature Review and Discussion of Treatment

Benjamin Savoye et al. Eur J Case Rep Intern Med. .

Abstract

Introduction: Immunoglobulin A vasculitis (IgAV) is a small-vessel vasculitis with IgA-dominant immune deposits. IgAV frequently involves the skin, gastrointestinal tract, joints and kidneys. In contrast to other types of small-vessel vasculitis, IgAV is rarely complicated by intra-alveolar haemorrhage (IAH).

Methods/results: We describe a patient with relapsing bladder cancer who presented with IAH during the course of IgAV successfully treated with corticosteroids alone.

Conclusion: This case report reminds us that IgAV can manifest with IAH. There are no robust data to support the systematic use of cyclophosphamide or plasma exchange as first-line therapy for IgAV with IAH.

Learning points: Intra-alveolar haemorrhage in IgA vasculitis is an uncommon but important condition.The treatment strategies for IgA vasculitis and intra-alveolar haemorrhage and their rare association are discussed with reference to the literature.

Keywords: Henoch-Schönlein purpura; IgA vasculitis; cancer; intra-alveolar haemorrhage.

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Conflict of interest statement

Conflicts of Interests: The Authors declare that there are no competing interests.

Figures

Figure 1
Figure 1
Skin histopathology (H&E) showing leukocytoclastic vasculitis (A, B). Skin indirect immunofluorescence histopathology showing perivascular IgA deposits (C)
Figure 2
Figure 2
Thoracic computed tomography (CT) scan showing focal and bilateral parenchymatous infiltrates (ground grass)
See this image and copyright information in PMC

References

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