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Coronavirus disease 2019‐associated immunoglobulin A vasculitis/Henoch–Schönlein purpura: A case report and review
Author(s) -
Jedlowski Patrick M.,
Jedlowski Mahdieh F.
Publication year - 2022
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.16211
Subject(s) - vasculitis , henoch schonlein purpura , medicine , purpura (gastropod) , immunoglobulin a , immunology , palpable purpura , systemic vasculitis , glomerulonephritis , disease , antibody , pathology , immunoglobulin g , kidney , biology , ecology
Immunoglobulin A (IgA) vasculitis or Henoch–Schönlein purpura is a predominantly pediatric disease occurring after a triggering viral or bacterial infection. Conversely, drug exposure is the most common inciting event in adult cases of IgA vasculitis. Recently, data has suggested a temporal association between coronavirus disease 2019 (COVID‐19) and the development of IgA vasculitis in children and adults. Here, we describe a case of IgA vasculitis with nephritis in a 70‐year‐old man with COVID‐19 and perform a comprehensive review of eight reported cases of suspected COVID‐19‐associated IgA vasculitis. When compared to classical IgA vasculitis, COVID‐19‐associated IgA vasculitis exclusively affects males ( p < 0.00002) and is more common in adults ( p < 0.005). Among cases of COVID‐19‐associated IgA vasculitis, adult cases were associated with significantly more arthralgia than pediatric cases ( p = 0.04). In cases where skin biopsy was obtained, direct immunofluorescence (DIF) was negative for IgA in 50% of cases; thereafter, kidney biopsy DIF was positive for IgA in all cases. With this study, we provide support for an association between IgA vasculitis and severe acute respiratory syndrome coronavirus 2 infection and provide clinical information differentiating its manifestations from classical IgA vasculitis.