Immunoglobulin A vasculitis in association with invasive meningococcal disease

Immunoglobulin A vasculitis is uncommon in adults and is frequently associated with an identifiable trigger, most often infection. Invasive meningococcal disease is a rare but life-threatening infection caused by Neisseria meningitidis. We report the case of an 18-year-old Indigenous Australian woman who presented with fever, purpuric rash, ankle synovitis, abdominal pain, and systemic inflammation. A skin biopsy demonstrated leukocytoclastic vasculitis with immunoglobulin A deposition on immunohistochemistry, and blood cultures subsequently identified N. meningitidis serogroup B. Cerebrospinal fluid studies were unremarkable. The patient was treated with intravenous ceftriaxone, with complete clinical resolution and no recurrence at a 6-month follow-up. This case highlights a previously unreported association between immunoglobulin A vasculitis and invasive meningococcal disease in an adult patient, and it expands the spectrum of infectious triggers associated with adult-onset immunoglobulin A vasculitis.