Wallace Carly E, Sharma Amit
Dermatology, College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, USA.
Family Medicine, College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Elmira, USA.
Cureus. 2022 Apr 9;14(4):e23987. doi: 10.7759/cureus.23987. eCollection 2022 Apr.
Immunoglobulin A (IgA) vasculitis is a small blood vessel vasculitis that is mediated by immune complex deposition. While it is the most common cause of childhood vasculitis, the disease is uncommon in adults with variable clinical manifestations. A 65-year-old female presented with a diffuse erythematous, pruritic, painful rash across her legs, back, and arms of 12 days' duration. Associated symptoms included fatigue, lower extremity swelling, and migratory arthralgias of the knees and ankles. Skin examination revealed edematous, blanchable, erythematous, annular papules and plaques on the legs, back, and arms with pitting edema of the lower legs. Laboratory testing revealed an elevated erythrocyte sedimentation rate, hypoalbuminemia, proteinuria, hematuria, and a positive antistreptolysin O titer, indicative of recent group A infection. Treatment with systemic corticosteroids led to a resolution of all her symptoms. Adult onset IgA vasculitis differs in clinical manifestation and treatment from that of the pediatric population. This case demonstrates the importance of considering IgA vasculitis as a differential diagnosis in adults presenting with small vessel vasculitis.
免疫球蛋白A（IgA）血管炎是一种由免疫复合物沉积介导的小血管血管炎。虽然它是儿童血管炎最常见的病因，但在成年人中并不常见，临床表现多样。一名65岁女性出现持续12天的弥漫性红斑、瘙痒、疼痛性皮疹，累及双腿、背部和手臂。相关症状包括疲劳、下肢肿胀以及膝关节和踝关节的游走性关节痛。皮肤检查发现双腿、背部和手臂有水肿性、可压褪色的红斑、环状丘疹和斑块，伴有小腿凹陷性水肿。实验室检查显示红细胞沉降率升高、低白蛋白血症、蛋白尿、血尿以及抗链球菌溶血素O滴度阳性，提示近期A组感染。全身使用糖皮质激素治疗后，她的所有症状均得到缓解。成人起病的IgA血管炎在临床表现和治疗方面与儿童患者不同。该病例表明，对于出现小血管血管炎的成年人，将IgA血管炎作为鉴别诊断的重要性。
