Adult IgA vasculitis or Henoch-Schonlein rheumatoid purpura is a rare clinical entity, which is characterized by tissue deposits of immune complexes containing type A immunoglobulins. A 24-year-old man without any particular history, especially concerning past infections, displayed purpuric petechial and ecchymotic skin lesions, which were infiltrated and vascular in nature, as well as associated with polyarthralgia of the elbows and knees, in addition to spasmodic abdominal pain. The blood analysis revealed a discrete inflammatory syndrome with a C-reactive protein (CRP) level at 37 mg/L, the rest of the workup including hemostasis being unremarkable. The renal assessment showed significant proteinuria at 0.73g/24 hours without renal failure. Skin histology exhibited a lymphocytic vasculitis lesion and perivascular infiltrates consisting of mononuclear cells, without fibrinoid necrosis. The diagnosis of subacute IgA vasculitis was established based on the criteria of the American College of Rheumatology and EULAR/PRINTO/PRES (European League Against Rheumatism/Paediatric Rheumatology INternational Trials Organisation/Paediatric Rheumatology European Society). A cortico-resistance of the skin lesions was noted following 21 days of treatment, which eventually resolved at 1 month.
Key Words
Henoch-Schonlein, melena, purpura