Adult-Onset IgA Vasculitis in Early Pregnancy Following Rhinovirus/Enterovirus and Streptococcal Infection: A Case...

IgA vasculitis (IgAV) is an immune complex-mediated systemic small-vessel vasculitis that is mostly seen in children and triggered by respiratory or gastrointestinal tract infections. Rarely, it may occur in adults, with rare cases developing during pregnancy. We herein described a unique case of a young lady who developed skin rashes and inflammatory joint pains secondary to IgAV preceded by two bouts of respiratory tract infection (Streptococcal throat infection and rhinovirus/enterovirus infection). She was also found to be in early pregnancy (2 weeks gestational age) at onset of IgAV. She was subsequently managed carefully by the rheumatologist and obstetrician with a tapering course of corticosteroid monotherapy without initiation of steroid-sparing immunosuppressant. This case highlights the unique entity of managing adult IgAV in pregnancy, for which therapeutic considerations require balancing the degree of immunosuppression and the need to avoid active rheumatic disease which both pose significant risks in pregnancy.