IgA vasculitis with gastrointestinal involvement in an adolescent: A case report and literature review

Abstract

IgA vasculitis is the most common systemic vasculitis in childhood and adolescence, characterized by the deposition of IgA immune complexes in small blood vessels. Clinical manifestations include palpable purpura, abdominal pain, arthritis, and possible renal involvement; gastrointestinal involvement can mimic an acute abdomen and present a diagnostic challenge. We present the case of a 17-year-old adolescent patient with severe abdominal pain associated with purpuric lesions on the lower extremities. Laboratory studies, abdominopelvic computed tomography, and digestive endoscopy were performed, in addition to a skin biopsy for histopathological examination; direct immunofluorescence was not performed because it was not available at the hospital. The endoscopy revealed gastrointestinal involvement, and the skin biopsy showed leukocytoclastic vasculitis of small vessels, establishing the definitive diagnosis of IgA vasculitis (IgAV). The patient was treated with oral glucocorticoids, and due to persistent abdominal pain, received intravenous pulses, progressing favorably with no evidence of renal involvement. This case highlights the importance of considering IgA vasculitis in adolescents with acute abdominal pain and palpable purpura, as timely clinical and pathological diagnosis