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Severe Atypical Systemic IgA Vasculitis in an Adult Male: a Case Report and Review of Literature

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Abstract

Systemic IgA vasculitis classically affects skin, joints, gastrointestinal system, and kidneys. However, in a minority of cases, other organs are affected, making it more challenging for physicians to recognize and diagnose the disease. We present the case of a rare form of IgA vasculitis with involvement of both heart and lungs. We report a case of a 72-year old man who presented to our hospital with an atypical clinical course of severe IgA vasculitis. The disease did not only affect the skin, kidneys, and gastrointestinal system, but also the heart and lungs, which made it more challenging to diagnose the patient. Our patient gradually recovered after administration of high doses of (methyl)prednisolone. However, temporary ICU admission and renal replacement therapy were needed because of acute kidney failure. Involvement of the lungs and the heart in IgA vasculitis has been reported in literature, but is uncommon. It is important for clinicians to be aware of atypical presentations of IgA vasculitis in order to reduce doctor delay and improve treatment outcomes.

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Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Code Availability

Code availability is not applicable to this article since no software application or custom code was used.

Abbreviations

COPD:

Chronic obstructive pulmonary disease

CRP:

C-reactive protein

CT:

Computed tomography

CVVH:

Continuous veno-venous hemofiltration

ECG:

Electrocardiogram

eGFR:

Estimated glomerular filtration rate

HIV:

Human immunodeficiency virus

ICU:

Intensive care unit

IHD:

Intermittent hemodialysis

IgA/IgG/IgM:

Immunoglobulin A/G/M

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Authors and Affiliations

  1. Department of Internal Medicine, Meander Medical Center, Amersfoort, The Netherlands

    Djimme T. van Etten & M. Hagelstein-Rotman

  2. Department of Internal Medicine, Division of Nephrology, Meander Medical Center, Amersfoort, The Netherlands

    E. C. Hagen & H. H. F. Remmelts

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  1. Djimme T. van Etten
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  2. M. Hagelstein-Rotman
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  3. E. C. Hagen
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  4. H. H. F. Remmelts
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Contributions

Majority of this article was written by DTE and HHFR. MHR and ECH were involved in the clinical case and provided additional adjustments, corrections, and guidance.

Corresponding author

Correspondence to Djimme T. van Etten.

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van Etten, D.T., Hagelstein-Rotman, M., Hagen, E.C. et al. Severe Atypical Systemic IgA Vasculitis in an Adult Male: a Case Report and Review of Literature. SN Compr. Clin. Med. 5, 126 (2023). https://doi.org/10.1007/s42399-023-01466-4

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