Yamamoto Naoki, Dejima Akihiro, Hasatani Kenkou
Department of Internal Medicine, Suzu General Hospital, Suzu, JPN.
Cureus. 2021 Mar 13;13(3):e13863. doi: 10.7759/cureus.13863.
We present the case of a 79-year-old man on hemodialysis with immunoglobulin A (IgA) vasculitis. He developed palpable purpura three weeks after having pneumonia. A skin biopsy showed leukocytoclastic vasculitis with IgA and C3 deposition. He received a topical corticosteroid for his IgA vasculitis. He was also diagnosed with a metastatic liver lesion, which was thought to be of colorectal origin because of the elevations in carcinoembryonic antigen and cancer antigen 19-9 levels. The skin biopsy played an important role in the diagnosis of the patient on hemodialysis. Pneumonia and a metastatic liver lesion thought to be from colorectal cancer might be related to the pathogenesis of IgA vasculitis.
我们报告一例79岁接受血液透析的免疫球蛋白A(IgA)血管炎男性患者。他在患肺炎三周后出现可触及的紫癜。皮肤活检显示白细胞破碎性血管炎伴IgA和C3沉积。他因IgA血管炎接受了外用糖皮质激素治疗。他还被诊断出有肝脏转移瘤,由于癌胚抗原和癌抗原19-9水平升高,考虑其起源于结直肠癌。皮肤活检在该血液透析患者的诊断中发挥了重要作用。肺炎和考虑源自结直肠癌的肝脏转移瘤可能与IgA血管炎的发病机制有关。