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J Dermatol . Coronavirus disease 2019-associated immunoglobulin A vasculitis/Henoch-Schönlein purpura: A case report and review

tetano

Editor, Senior Moderator
J Dermatol


. 2021 Nov 5.
doi: 10.1111/1346-8138.16211. Online ahead of print.
Coronavirus disease 2019-associated immunoglobulin A vasculitis/Henoch-Schönlein purpura: A case report and review


Patrick M Jedlowski[SUP] 1 [/SUP], Mahdieh F Jedlowski[SUP] 1 [/SUP]



Affiliations

Abstract

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.

Keywords: Henoch-Schönlein Purpura; coronavirus disease 2019; cutaneous small vessel vasculitis; immunoglobulin A vasculitis; severe acute respiratory syndrome coronavirus 2.
 
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