Although the cause of the disease remains unknown, immune complexes of IgA and unidentified antigens seem to play a central pathogenic role. The diagnosis is easily established in the presence of purpura, but may be challenging in its absence, especially when colicky abdominal pain precedes the cutaneous lesions.
IgA vasculitis is usually a self-limited disease with a benign course and symptomatic arthralgia is is sufficient for most; in severe cases, however, corticosteroids are necessary. We describe the case of a young adult male presenting with severe abdominal arthralgia is, vomiting and fever Clinical examination, abdominal ultrasound and plain abdominal radiography excluded an acute abdomen.
The occurrence of arthralgia involving both knees and erosive duodenitis at endoscopy, 48 hours upon admission, suggested the diagnosis of IgA vasculitis, confirmed on the following day by the presence of typical purpuric rash on the lower extremities.
Corticosteroid therapy led to the resolution of all gastrointestinal and joint manifestations as well as to a significant improvement of cutaneous purpura.
- Comprimate filmate ovale, uşor biconvexe, de culoare albastru închis, marcate pe una dintre feţe.
- Comprimate artrită prirevmatoidnom
- arthralgias - Traducere în română - exemple în engleză | Reverso Context
However, during the 3rd week of corticosteroid treatment, the patient developed watery diarrhea and the clinical suspicion of Clostridium difficile infection CDI was confirmed. The treatment with metronidazole led to the resolution of diarrhea.
The peculiarity of this case resides in several aspects: the gastrointestinal and joint manifestations preceded purpura, making diagnosis more difficult; CDI is an extremely rare complication of IgA vasculitis, being, in fact, the second case reported in adults in the literature.