SHM Converge Scientific Abstract ePoster Gallery-Immunoglobulin a Vasculitis in the Geriatric Population

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This case report describes IgA vasculitis in a 75-year-old woman, an uncommon presentation in the geriatric population. IgA vasculitis, formerly known as Henoch-Schönlein purpura, is a small-vessel leukocytoclastic vasculitis caused by IgA immune complex deposition, typically affecting the skin, gastrointestinal tract, joints, and kidneys. It is common in children but rare in older adults.<br /><br />The patient presented with 3 days of nausea, vomiting, diarrhea, abdominal pain, weakness, bilateral lower-extremity edema, and a burning purpuric rash. Workup showed acute kidney injury, nephrotic-range proteinuria, hematuria, and hypoalbuminemia. Her renal function did not improve with fluids. Skin biopsy revealed IgA deposition in vessel walls, and kidney biopsy confirmed IgA-associated crescentic glomerulonephritis. Evaluation for infection, rheumatologic disease, and malignancy was negative.<br /><br />She was treated with three days of methylprednisolone, which led to marked clinical improvement, and was discharged on a 14-day prednisone course with follow-up for rheumatology, primary care, and further malignancy screening. The authors emphasize that adult and geriatric IgA vasculitis may have worse outcomes than pediatric disease and can present atypically, with hypertension, renal impairment, hypoalbuminemia, and crescentic glomerulonephritis more common in older patients. Prompt recognition and treatment are important to reduce complications and disease progression.

Asset Subtitle

Jonelle Douglas

Meta Tag

Author List Chris Musgrove, Jonelle Douglas, Marc Roberge, Opeoluwa Dehinbo, Salahuddin Nasir, Tanisha Kaur

Category Clinical Vignettes

Concept IgA Vasculitis

Concept IgA Deposition

Concept Small-Vessel Vasculitis

Concept Purpura

Concept Renal involvement

Distinguished Non-Finalist

Presenter Organization University of Pittsburgh Medical Center

Presenting Author Jonelle Douglas

Track Adult

Keywords

IgA vasculitis

Henoch-Schönlein purpura

geriatric patient

purpuric rash

acute kidney injury

nephrotic-range proteinuria

crescentic glomerulonephritis

IgA deposition

methylprednisolone

prednisone treatment

IgA Vasculitis

IgA Deposition

Small-Vessel Vasculitis

Purpura

Renal involvement