IgA vasculitis (formerly Henoch-Schönlein purpura) in an adult with systemic lupus erythematosus.
We report a case of a 65-year-old man with systemic lupus erythematosus (SLE) and antiphospholipid syndrome, presenting palpable purpuric lesions, necrotic blisters and swelling ankles, after a previous tracheobronchitis episode. Laboratory data were remarkable for mild proteinuria and imaging studies were normal. A skin biopsy showed IgA deposits on superficial dermal capillaries and IgA vasculitis (IgAV) (former Henoch-Schönlein purpura) was assumed. The patient was treated with colchicine, deflazacort and azathioprine, but as a regression in the purpuric lesions was noted, a decline in renal function was detected. A kidney biopsy revealed mesangial proliferation with IgA deposition and IgAV nephritis was considered. Immunosuppressive treatment was adjusted, with progressive normalisation of renal function and disappearance of proteinuria over a monthly follow-up; after 6 months, total remission was achieved. To the best of our knowledge, this is the first reported case of IgAV in an adult patient with SLE.
Autoimmune Disease Unit, Internal Medicine 2 Department, Hospital Curry Cabral, Lisbon, Portugal.
Vera
V
Bernardino
Department of Dermatology, Hospital Curry Cabral, Lisbon, Portugal.
Pedro
P
Mendes-Bastos
Autoimmune Disease Unit, Internal Medicine 2 Department, Hospital Curry Cabral, Lisbon, Portugal.
Ana
A
Rodrigues
Autoimmune Disease Unit, Internal Medicine 2 Department, Hospital Curry Cabral, Lisbon, Portugal Hospital Curry Cabral, Lisbon, Portugal.
Nuno
N
Riso
D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D006801:Humans; D011695:IgA Vasculitis / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D008297:Male; D017257:Ramipril / Q000008:administration & dosage*; D012074:Remission Induction
D000959:Antihypertensive Agents; D007166:Immunosuppressive Agents; D017257:Ramipril