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Atypical presentation of immunoglobulin A vasculitis mimicking acute appendicitis in a pediatric patient: a case

Rashid Hayajneh1, Kariman Ghazal2, Ghassan Nakib3

  • 1Department of Surgery, Masaryk University, Brno, Czech Republic.

Future Science OA
|September 17, 2025
PubMed

Insights

Pediatric appendicitis mimics can mask Immunoglobulin A (IgA) vasculitis. This case shows how vasculitis can present as abdominal pain, requiring careful diagnosis beyond initial surgical evaluation.

Area of Science:

  • Pediatric Surgery
  • Pediatric Rheumatology
  • Pediatric Gastroenterology

Background:

  • Acute appendicitis is a common surgical emergency in children, but diagnosis can be challenging due to overlapping symptoms with other conditions.
  • Atypical presentations of abdominal pain in children necessitate consideration of systemic inflammatory disorders.

Purpose of the Study:

  • To present a case of a pediatric patient initially suspected of appendicitis.
  • To highlight the diagnostic challenges in differentiating appendicitis from other causes of abdominal pain.
  • To emphasize the importance of considering Immunoglobulin A (IgA) vasculitis in pediatric abdominal emergencies.

Main Methods:

  • Case report of a 4-year-old female with initial symptoms of appendicitis.
  • Diagnostic workup including imaging studies and laparoscopic appendectomy.
  • Postoperative investigation involving laboratory tests and clinical assessment for systemic inflammatory conditions.

Main Results:

  • Laparoscopic appendectomy revealed no appendicitis but showed vasculitic changes in the ileum.
  • Patient subsequently developed a purpuric rash and elevated C-reactive protein (CRP).
  • Diagnosis of Immunoglobulin A (IgA) vasculitis was confirmed through laboratory tests and clinical findings.

Conclusions:

  • This case underscores the diagnostic complexity when appendicitis-like symptoms are caused by atypical IgA vasculitis.
  • Considering systemic inflammatory diseases is crucial for pediatric abdominal pain, especially when initial findings are inconclusive.
  • A multidisciplinary approach, including rheumatological consultation, is vital for accurate diagnosis and management of such cases.

Keywords:
Acute appendicitisIgA vasculitisabdominal surgerydiagnostic challengesgastrointestinal involvementpediatric abdominal painpurpuravasculitis

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