Immunoglobulin A vasculitis presenting as terminal ileitis in late adulthood

Adult-onset immunoglobulin (IgA) vasculitis presenting as terminal ileitis is a rare clinical encounter which can mimic inflammatory bowel disease or infectious gastroenteritis. A high index of clinical suspicion is required to reach the correct diagnosis and to implement the appropriate management plans. Herein, we report a case of an elderly female presenting with a short history of abdominal pain, vomiting, bloody diarrhoea, fatigue and reduced appetite. Based on the blood tests and imaging, she was initially managed as having an infective or inflammatory bowel condition. Subsequently, she developed a vasculitic rash in her lower limbs with accompanying renal involvement including haematuria and sub-nephrotic range proteinuria. She underwent a renal biopsy which confirmed the diagnosis of IgA vasculitis. She was started on a course of corticosteroid therapy which induced clinical remission.