Diffuse Alveolar Hemorrhage in IgA Vasculitis with an Atypical Presentation

Intern Med. 2018 Jan 1;57(1):81-84. doi: 10.2169/internalmedicine.8984-17. Epub 2017 Oct 16.

Abstract

IgA vasculitis (IgAV) commonly occurs in young children, who present with a tetrad of purpura, abdominal pain, arthralgia and nephritis. Diffuse alveolar hemorrhage (DAH) is a rare complication of IgAV. We herein report an adult case of IgAV with a presentation of DAH and nephritis (pulmonary renal syndrome, PRS), but without other typical manifestations, such as purpura, abdominal pain and arthralgia. A 33-year-old man presented with hemoptysis and a low-grade fever and was diagnosed to have IgAV based on the results of a renal biopsy. Treatment with corticosteroids, cyclophosphamide, and plasmapheresis was effective. IgAV should therefore be considered in the differential diagnosis of adult PRS.

Keywords: Henöch-Schonlein purpura; IgA vasculitis; adult; diffuse alveolar hemorrhage; plasmapheresis; pulmonary renal syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Cyclophosphamide / therapeutic use
  • Glomerulonephritis / drug therapy*
  • Glomerulonephritis / etiology*
  • Hemorrhage / drug therapy
  • Hemorrhage / etiology*
  • Humans
  • Immunoglobulin A / adverse effects*
  • Immunologic Factors / adverse effects*
  • Immunosuppressive Agents / therapeutic use
  • Lung Diseases / drug therapy
  • Lung Diseases / etiology*
  • Male
  • Treatment Outcome
  • Vasculitis / complications*

Substances

  • Adrenal Cortex Hormones
  • Immunoglobulin A
  • Immunologic Factors
  • Immunosuppressive Agents
  • Cyclophosphamide