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Published online: 2024-11-22

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IgA vasculitis in an adult patient

Monika Grochowska-Rak1, Katarzyna Kulig1, Arleta Grabowska1, Violetta Karlińska-Jonkisz1

Abstract

Henoch–Schönlein purpura (HSP) is a form of small-vessel vasculitis characterized by the deposition of immunoglobulin A (IgA) in vascular walls. It predominantly affects children, often following a respiratory tract infection, and is marked by a classic tetrad of symptoms: palpable purpura, arthritis, abdominal pain, and haematuria. Though typically a paediatric condition, HSP can also occur in adults, where it may present with similar but sometimes more severe manifestations.

This article presents a case of IgA vasculitis with renal involvement in an adult patient treated with dapsone. Henoch–Schönlein purpura in adults presents unique challenges and requires a comprehensive, interdisciplinary approach to management. The absence of standardized treatment guidelines for adults highlights the need for further research and development of clear protocols. Collaboration among specialists in dermatology, nephrology, and other relevant fields is essential for optimizing patient care and outcomes in managing this complex condition.

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References

  1. Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013; 65(1): 1–11.
  2. González-Gay M, López-Mejías R, Pina T, et al. IgA vasculitis: genetics and clinical and therapeutic management. Current Rheumatology Reports. 2018; 5(24).
  3. Piram M, Mahr A. Epidemiology of immunoglobulin A vasculitis (Henoch-Schönlein): current state of knowledge. Curr Opin Rheumatol. 2013; 25(2): 171–178.
  4. Audemard-Verger A, Pillebout E, Guillevin L, et al. IgA vasculitis (Henoch-Shönlein purpura) in adults: diagnostic and therapeutic aspects. Autoimmun Rev. 2015; 14(7): 579–585.
  5. Wetter DA, Dutz JP, Shinkai K, Fox LP. Zapalenia naczyń skóry. In: Rudnicka L, Bolognia JL, Schaffer JV, Cerroni L. ed. Dermatologia. Fourth Edition. Medipage, Warszawa 2022: 435–467.
  6. Song Y, Huang X, Yu G, et al. Pathogenesis of IgA Vasculitis: an up-to-date review. Front Immunol. 2021; 12: 771619.
  7. Rasmussen C, Tisseyre M, Garon-Czmil J, et al. Drug-induced IgA vasculitis in children and adults: revisiting drug causality using a dual pharmacovigilance-based approach. Autoimmun Rev. 2021; 20(1): 102707.
  8. Jedlowski PM, Jedlowski MF. Coronavirus disease 2019-associated immunoglobulin A vasculitis/Henoch-Schönlein purpura: a case report and review. J Dermatol. 2022; 49(1): 190–196.
  9. Messova A, Pivina L, Muzdubayeva Z, et al. COVID-19 and new onset IgA vasculitis: a systematic review of case reports. J Emerg Nurs. 2022; 48(4): 348–365.
  10. Hočevar A, Rotar Z, Jurčić V, et al. IgA vasculitis in adults: the performance of the EULAR/PRINTO/PRES classification criteria in adults. Arthritis Res Ther. 2016; 18: 58.
  11. Mills JA, Michel BA, Bloch DA, et al. The American college of rheumatology 1990 criteria for the classification of Henoch-Schönlein purpura. Arthritis Rheum. 1990; 33(8): 1114–1121.
  12. Maritati F, Canzian A, Fenaroli P, et al. Adult-onset IgA vasculitis (Henoch-Schönlein): update on therapy. Presse Med. 2020; 49(3): 104035.
  13. Reamy BV, Servey JT, Williams PM. Henoch-Schönlein purpura (IgA vasculitis): rapid evidence review. Am Fam Physician. 2020; 102(4): 229–233.
  14. Audemard-Verger A, Terrier B, Dechartres A, et al. Characteristics and management of IgA vasculitis (Henoch-Schönlein) in adults: data from 260 patients included in a French multicenter retrospective survey. Arthritis Rheumatol. 2017; 69(9): 1862–1870.
  15. Van de Perre E, Jones RB, Jayne DRW. IgA vasculitis (Henoch-Schönlein purpura): refractory and relapsing disease course in the adult population. Clin Kidney J. 2021; 14(8): 1953–1960.