{"title":"Steroid-Dependent Recurrent IgA Vasculitis in a 19-Year-Old Woman.","authors":"Hannah Berrett, Shivangi Gohil, Rebecca Kurian, Patricia Neyman","doi":"10.36518/2689-0216.1660","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Immunoglobulin A (IgA) vasculitis is common in children and typically resolves spontaneously. However, when presenting in adults, it is more likely to be severe and recurrent.</p><p><strong>Case presentation: </strong>We present the case of a 19-year-old female patient with recurrent steroid-dependent IgA vasculitis. She had a history of a prolonged episode of IgA vasculitis in childhood. She presented to our hospital with proteinuria and a painful, palpable purpuric rash on her bilateral lower extremities. She was treated with high-dose intravenous steroids. When steroids were tapered, the patient had a recurrence of her painful rash. Over several months, she developed steroid-induced hyperglycemia and worsening proteinuria.</p><p><strong>Conclusion: </strong>Recent studies have shown that corticosteroids have limited effect on long-term outcomes in IgA vasculitis, but steroid-sparing agents have potential for the treatment of recurrent steroid-dependent IgA vasculitis.</p>","PeriodicalId":73198,"journal":{"name":"HCA healthcare journal of medicine","volume":"5 4","pages":"453-458"},"PeriodicalIF":0.0000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11404596/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"HCA healthcare journal of medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.36518/2689-0216.1660","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Immunoglobulin A (IgA) vasculitis is common in children and typically resolves spontaneously. However, when presenting in adults, it is more likely to be severe and recurrent.
Case presentation: We present the case of a 19-year-old female patient with recurrent steroid-dependent IgA vasculitis. She had a history of a prolonged episode of IgA vasculitis in childhood. She presented to our hospital with proteinuria and a painful, palpable purpuric rash on her bilateral lower extremities. She was treated with high-dose intravenous steroids. When steroids were tapered, the patient had a recurrence of her painful rash. Over several months, she developed steroid-induced hyperglycemia and worsening proteinuria.
Conclusion: Recent studies have shown that corticosteroids have limited effect on long-term outcomes in IgA vasculitis, but steroid-sparing agents have potential for the treatment of recurrent steroid-dependent IgA vasculitis.
背景:免疫球蛋白 A(IgA)血管炎常见于儿童,通常可自行缓解。然而,当成人发病时,病情更可能严重且反复发作:本病例为一名反复发作的类固醇依赖型 IgA 血管炎的 19 岁女性患者。她在童年时曾有过长时间的 IgA 血管炎病史。她因蛋白尿和双下肢疼痛、可触及的紫癜性皮疹来我院就诊。她接受了大剂量静脉类固醇治疗。类固醇减量后,患者的疼痛性皮疹复发。几个月后,她又出现了类固醇引起的高血糖和蛋白尿:最近的研究表明,皮质类固醇对 IgA 血管炎的长期疗效影响有限,但节省类固醇的药物在治疗复发性类固醇依赖型 IgA 血管炎方面具有潜力。