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A Case Series of Adult Patients Diagnosed with IgA Vasculitis Requiring Systemic Immunosuppression

Fenfen Cai, Lisa M. Phipps, P. Wu, Ming-Wei Lin

The American journal of case reports, 2021

9 citations

Abstract

Case series Patients: Female, 31-year-old • Male, 43-year-old • Female, 64-year-old Final Diagnosis: IgA vasculitis Symptoms: Abdominal pain • haematuria • hemoptysis • joint pain • proteinuria • rash Medication: — Clinical Procedure: — Specialty: Immunology Objective: Rare disease Background: IgA vasculitis (IgAV) is a rare and potentially life-threatening small-vessel vasculitis in adults. The disease course is often more severe than its childhood counterpart. The disease is noted for its heterogeneous presentation with varying severity. There are no current treatment guidelines for severe multi-organ involvement of IgAV. The treatment approaches based on the clinical discretion of treating doctors remain controversial, especially regarding the role, duration, and type of immunosuppression. Case Reports: We present 3 cases of severe multi-organ IgAV encountered at our tertiary referral center between 2016 and 2021, which were treated with different immunosuppression regimens, including combination of systemic corticosteroids, oral immunosuppressants (azathioprine, mycophenolate, and sirolimus), rituximab, and cyclophosphamide. In these patients, IgAV presented differently but were all organ-threatening or life-threatening in nature. IgAV in all patients responded to therapies; however, infection complicating underlying comorbidities was the cause of death in 1 patient and the cause of comorbidities in the other 2. Other treatment-related complications included weight gain,…

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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

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