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Diffuse Alveolar Hemorrhage in IgA Vasculitis with an Atypical Presentation
Yuhei Ito1, Machiko Arita1, Shogo Kumagai1
1Department of Respiratory Medicine, Kurashiki Central Hospital, Japan.
Internal Medicine (Tokyo, Japan)
|October 17, 2017
Summary
IgA vasculitis (IgAV) can rarely affect adults, presenting atypically with diffuse alveolar hemorrhage and nephritis. Early consideration of IgAV is crucial for diagnosing adult pulmonary renal syndrome.
Area of Science:
- Nephrology
- Pulmonology
- Rheumatology
Background:
- IgA vasculitis (IgAV) typically affects children with characteristic symptoms like purpura and nephritis.
- Diffuse alveolar hemorrhage (DAH) is an uncommon but severe complication of IgAV.
Observation:
- A 33-year-old man presented with hemoptysis and fever, exhibiting DAH and nephritis.
- The patient lacked the typical IgAV manifestations of purpura, abdominal pain, and arthralgia.
Findings:
- Renal biopsy confirmed IgA vasculitis (IgAV) as the underlying diagnosis.
- Treatment involving corticosteroids, cyclophosphamide, and plasmapheresis proved effective.
Implications:
- This case highlights IgAV as a potential cause of adult pulmonary renal syndrome (PRS).
- Clinicians should include IgAV in the differential diagnosis for adult PRS, even without classic symptoms.