PDF(Pubmed)
Abstract：
BACKGROUND Immunoglobulin A (IgA) vasculitis is a small-vessel vasculitis characterized by the deposition of IgA immune complexes primarily in the skin, kidneys, and gastrointestinal tract. While it predominantly affects children, cases in adults are associated with more severe manifestations. Evidence suggests that infectious triggers play a pivotal role in its etiology. Often, it follows a self-limiting course and doesn\'t necessitate intervention. CASE REPORT We present the case of a 51-year-old man who presented with a maculopapular rash, arthralgia, and abdominal pain. An examination revealed a purpuric rash on lower extremities and abdomen. A lower extremity duplex ultrasound identified deep vein thrombosis (DVT) in the right leg. Skin biopsy of the rash confirmed the diagnosis of IgA vasculitis, demonstrating perivascular neutrophilic infiltrate and IgA complex deposition. Stool studies revealed co-infection with Cryptosporidium and Giardia. The patient was treated with a prednisone taper with significant improvement in symptoms. CONCLUSIONS This case highlights the potential role of Cryptosporidium as a trigger for IgA vasculitis. The presence of concurrent infections underscores the complex interplay between infections and the development of IgA vasculitis. The co-infection with Giardia suggests that a secondary infection may be involved, further complicating the disease\'s etiology. The observation of DVT suggests a possible link between IgA vasculitis and a prothrombotic state. This report serves to expand the knowledge of IgA vasculitis triggers and associated complications, guiding clinicians in diagnosing and managing similar cases while emphasizing the importance of vigilance in adults with these symptoms.
摘要：
背景技术免疫球蛋白A(IgA)血管炎是一种小血管血管炎,其特征在于IgA免疫复合物主要沉积在皮肤中。肾脏，和胃肠道。虽然它主要影响儿童，成人病例与更严重的表现有关。有证据表明，感染性触发因素在其病因中起着关键作用。通常,它遵循一个自我限制的过程，不需要干预。案例报告我们介绍了一个51岁的男人，他出现了斑丘疹，关节痛,和腹痛。检查发现下肢和腹部有紫癜性皮疹。下肢双工超声检查发现右腿深静脉血栓形成（DVT）。皮疹的皮肤活检证实了IgA血管炎的诊断，显示血管周围嗜中性粒细胞浸润和IgA复合物沉积。粪便研究显示与隐孢子虫和贾第鞭毛虫共感染。患者接受泼尼松锥度治疗，症状明显改善。结论该病例强调了隐孢子虫作为IgA血管炎的潜在触发因素。并发感染的存在强调了感染与IgA血管炎发展之间复杂的相互作用。与贾第鞭毛虫共感染表明可能涉及继发感染，进一步复杂化的疾病的病因。DVT的观察表明IgA血管炎和血栓前状态之间可能存在联系。本报告有助于扩大IgA血管炎触发因素和相关并发症的知识，指导临床医生诊断和处理类似病例，同时强调对有这些症状的成年人保持警惕的重要性。
