Berrett Hannah, Gohil Shivangi, Kurian Rebecca, Neyman Patricia
Menorah Medical Center, Overland Park, KS.
HCA Healthc J Med. 2024 Aug 1;5(4):453-458. doi: 10.36518/2689-0216.1660. eCollection 2024.
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.
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.
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.
免疫球蛋白A（IgA）血管炎在儿童中很常见，通常会自发缓解。然而，在成人中发病时，病情更可能较为严重且易复发。
我们报告一例19岁复发性依赖类固醇的IgA血管炎女性患者。她童年时有过一次持续时间较长的IgA血管炎发作史。她因蛋白尿以及双侧下肢疼痛性可触及的紫癜性皮疹前来我院就诊。她接受了大剂量静脉注射类固醇治疗。当类固醇减量时，患者疼痛性皮疹复发。在几个月的时间里，她出现了类固醇诱导的高血糖症且蛋白尿加重。
最近的研究表明，皮质类固醇对IgA血管炎的长期预后影响有限，但类固醇节约剂有治疗复发性依赖类固醇的IgA血管炎的潜力。
