IgA Vasculitis in a Patient on Dialysis

Immunoglobulin A vasculitis (IgA Vasculitis), formerly called Henoch Schonlein Purpura (HSP) is a common systemic vasculitis in children. It is 33 times less common in adults than in children. Besides having dermatology manifestations in form of rash, it may affect other organs including kidney (nephritis that can lead to chronic kidney disease), arthritis, arthralgia, abdominal pain, bowel angina and gastrointestinal bleeding.

IgA vasculitis may result in IgA vasculitis nephritis (formerly called HSP nephritis). It shares a lot of similarities with IgA nephropathy, but has some notable differences as discussed later.

IgA vasculitis is rare in chronic kidney disease (CKD) patients on dialysis. We present a case of IgA vasculitis in an elderly male with end stage renal disease (ESRD) presumed to be due to diabetic nephropathy (kidney biopsy not available). He developed skin manifestations (rash). Skin biopsy confirmed the presence of IgA vasculitis.