Mortal Dangers of Adult-Onset IgA Vasculitis

Abstract

IgA vasculitis (IgAV), previously known as Henoch Schoenlein purpura (HSP), is a leukocytoclastic vasculitis subtype predominantly amongst the pediatric patient population involving IgA dominant immune complex deposits attacking small vessel walls. While it oftentimes follows upper respiratory infections and presents with palpable purpuras, IgAV can also present in the adult patient population and lead to systemic inflammation. In this case report, we present the case of an adult-onset IgAV complicated via gastrointestinal perforation, acute kidney injury secondary to IgA nephritis, and circulatory shock. A review of prognosis, complicating factors, and treatment methods was also conducted for reported adult-onset IgAV with an aim to elucidate similarities and differences to pediatric-onset IgAV. While there is no unified treatment approach, glucocorticoids and immunosuppressors such as rituximab have been observed to be an effective protocol.

Keywords: acute kidney injury care; adult iga vasculitis; gastrointestinal perforation; henoch-schönlein purpura (iga vasculitis); leukocytoclastic vasculitis (lcv).

Figure 1. Bilateral lower extremities with non-blanching petechiae

Figure 2. Colonoscopy finding of extensive gastrointestinal bleed