Common symptoms in a rare vascular disorder: A case report of Immunoglobulin A vasculitis

Abstract

INTRODUCTION: Immunoglobulin A vasculitis (IgAV), formerly known as Henoch-Schönlein purpura, is the most common form of systemic vasculitis in pediatric patients and often presents with symptoms that lend themselves to an extensive differential. PURPOSE: This case report describes a presentation of IgAV in a pediatric patient and provides the etiology, clinical symptoms, and treatment plan for this condition in a pediatric population. CASE REPORT: A 9-year-old male patient and his father presented to the walk-in clinic with a chief complaint of left ankle pain for 1 week and having mild GI discomfort for 2 weeks. X-ray imaging did not indicate a fracture of bones and the father attributed the GI discomfort to a recent illness suffered by the entire household. The patient was subsequently told to rest and ice his ankle and take appropriate ibuprofen for pain as needed and was advised to come back to the clinic if his condition did not improve or worsened. Four days after initial presentation, the patient's ankle pain and GI discomfort had not improved, and the patient had developed diffuse purpura over both lower extremities. To confirm the diagnosis of IgAV, labs ordered included complete blood count to rule out thrombocytopenia and coagulation panel to rule out coagulopathy, a urinalysis to evaluate for proteinuria and hematuria was also ordered. After discussion with the patient and his family, they were assured that supportive treatment with hydration, rest, and pain management was the recommended treatment. On 3 weeks follow up, the patient's symptoms had subsided. CONCLUSION: While IgAV is rare, the presenting symptoms for this patient were classic for IgAV. These symptoms are commonly encountered in primary care; thus, clinicians should include IgAV in their differential in order to avoid possible renal sequelae.