IgA Vasculitis in an Adult Man- a Case Report

Tasnova Mahin, Labeeba Faria, Akm Abu Mottaleb, F. Shumy, Md Abdul Oader
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Abstract

IgA vasculitis is rare in adult. A significant portion of adult cases may present with renal involvement. Although most of these cases can be managed symptomatically, some cases may require immunosuppressive treatment. Unless diagnosis and appropriate treatment is initiated early IgA nephropathy in adult may result in chronic kidney disease. Immunoglobulin A vasculitis (IgAV) is an acute disorder causing generalized vasculitis principally involving skin, gastrointestinal (GI) tract, kidneys and joints. Here, a 28 year old man was presented with purpuric rash with leg ulcer, inflammatory arthritis involving multiple joints, abdominal pain and vomiting. He had mild pedal edema and normal blood pressure. Investigations showed raised inflammatory markers, haematuria, and nephrotic range proteinuria with normal liver and renal function.  Biochemical and immunological evaluation of lupus nephritis, ANCA associated vasculitis and other causes of glomerulonephritis were negative. Renal biopsy with direct immunofluorescence showed features of IgA nephropathy. Patient was treated with steroid and mycophenolate mofetil with a good response. Bangladesh Med J. 2022 Sept; 51(3): 47-50
一名成年男子的 IgA 血管炎--病例报告
成人 IgA 血管炎很少见。相当一部分成人病例可能会出现肾脏受累。虽然大多数病例可以对症处理,但有些病例可能需要接受免疫抑制治疗。除非早期诊断并进行适当治疗,否则成人 IgA 肾病可能会导致慢性肾病。免疫球蛋白 A 血管炎(IgAV)是一种急性疾病,可引起全身性血管炎,主要累及皮肤、胃肠道、肾脏和关节。在这里,一名 28 岁的男子因紫癜性皮疹伴腿部溃疡、炎性关节炎累及多个关节、腹痛和呕吐而就诊。他有轻度足底水肿,血压正常。检查显示炎症指标升高、血尿、肾病范围蛋白尿,肝肾功能正常。 狼疮性肾炎、ANCA 相关性血管炎和其他原因引起的肾小球肾炎的生化和免疫学评估结果均为阴性。肾活检和直接免疫荧光显示出 IgA 肾病的特征。患者接受了类固醇和霉酚酸酯治疗,反应良好:47-50
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