SHM Converge Scientific Abstract ePoster Gallery-Iga Vasculitis Presenting as Abdominal Pain in an Adult Man

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A 29-year-old man with morbid obesity, asthma, and a chronic tracheostomy presented with 3 weeks of worsening epigastric abdominal pain, poor appetite, and nausea. Initial evaluation at an outside hospital was unrevealing except for gallstones without cholecystitis, so he was discharged. When his pain became constant and severe, he sought care again.<br /><br />On arrival, exam showed diffuse upper abdominal tenderness and a palpable purpuric rash on the flanks. Labs demonstrated renal involvement, including hematuria, proteinuria, and red blood cell casts on urine microscopy. Serologic workup for other vasculitides and related conditions was negative, including HIV, hepatitis panel, cryoglobulins, ANCA, and anti-GBM antibodies. CT abdomen/pelvis showed inflammatory changes near the second and third portions of the duodenum. A skin punch biopsy revealed leukocytoclastic vasculitis.<br /><br />Based on the combination of purpura, abdominal pain, renal findings, and biopsy-confirmed leukocytoclastic vasculitis, the patient was diagnosed with IgA vasculitis. He was started on prednisone, which led to rapid improvement in his abdominal pain. After discharge, he had complete resolution of gastrointestinal symptoms and rash on follow-up.<br /><br />This case highlights that IgA vasculitis, though more common in children, can occur in adults and may present more severely. Diagnosis in adults relies on careful integration of clinical findings, laboratory data, and histopathology, especially when atypical features delay recognition.

Asset Subtitle

Han Li

Meta Tag

Author List Brenna Zack, Han Li, Holly Perry

Category Clinical Vignettes

Concept IgA Vasculitis

Concept Palpable Purpura

Concept Renal involvement

Concept Adult presentation

Concept Abdominal Pain

Distinguished Non-Finalist

Presenter Organization Washington University in St. Louis

Presenting Author Han Li

Track Adult

Keywords

IgA vasculitis

leukocytoclastic vasculitis

purpuric rash

abdominal pain

renal involvement

hematuria

proteinuria

adult vasculitis

prednisone treatment

duodenal inflammation

IgA Vasculitis

Palpable Purpura

Renal involvement

Adult presentation

Abdominal Pain