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.
【저자키워드】 severe acute respiratory syndrome coronavirus 2, Coronavirus disease 2019, Henoch-Schönlein Purpura, immunoglobulin A vasculitis, cutaneous small vessel vasculitis, 【초록키워드】 COVID-19, coronavirus disease, coronavirus, pediatric, children, Infection, kidney, Adults, IgA, male, Bacterial infection, Vasculitis, immunofluorescence, immunoglobulin A, disease, association, manifestation, Support, acute respiratory syndrome, clinical information, arthralgia, purpura, positive, triggering, Affect, Pediatric case, classical, significantly more, reported, eight, suggested, was obtained, small vessel, with COVID-19, 【제목키워드】 Case report, immunoglobulin A, disease,