IgA Vasculitis in an Oldest-old Patient Successfully Treated with Glucocorticoid

A 94-year-old man was diagnosed with immunoglobulin A vasculitis (IgAV), and losartan was initiated. His renal function rapidly deteriorated over a month; therefore, methylprednisolone was administered intravenously for three days followed by oral prednisolone. Renal function improvement and both proteinuria and hematuria remission were observed within six months. Prednisolone tapering was completed at eight months. In this case, we monitored the patient carefully and started glucocorticoids as soon as the patient's renal function deteriorated. We were thus able to treat the patient with a relatively small dose of glucocorticoids in a short treatment period without any adverse events due to glucocorticoids.

[1]  C. Crowson,et al.  Clinical Characteristics of Biopsy-Proven IgA Vasculitis in Children and Adults: A Retrospective Cohort Study. , 2019, Mayo Clinic proceedings.

[2]  N. Tsuboi,et al.  Clinical and Pathological Characteristics of Elderly Japanese Patients with IgA Vasculitis with Nephritis: A Case Series , 2018, Internal medicine.

[3]  I. Narita,et al.  Distinct characteristics and outcomes in elderly-onset IgA vasculitis (Henoch-Schönlein purpura) with nephritis: Nationwide cohort study of data from the Japan Renal Biopsy Registry (J-RBR) , 2018, PloS one.

[4]  A. Bygum,et al.  Henoch-Schönlein Purpura: A Literature Review. , 2017, Acta dermato-venereologica.

[5]  C. Lohse,et al.  Henoch–Schönlein purpura and systemic disease in children: retrospective study of clinical findings, histopathology and direct immunofluorescence in 34 paediatric patients , 2015, The British journal of dermatology.

[6]  M. Pohl Henoch–Schönlein purpura nephritis , 2015, Pediatric Nephrology.

[7]  R. Ghrahani,et al.  Age of onset as a risk factor of renal involvement in Henoch-Schönlein purpura , 2014, Asia Pacific allergy.

[8]  A. Mahr,et al.  Epidemiology of immunoglobulin A vasculitis (Henoch–Schönlein): current state of knowledge , 2013, Current opinion in rheumatology.

[9]  A. Bakkaloğlu,et al.  EULAR/PRINTO/PRES criteria for Henoch–Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria , 2010, Annals of the rheumatic diseases.

[10]  A. Malaviya,et al.  Henoch-Schönlein's purpura in adults versus children/adolescents: A comparative study. , 2006, Clinical and experimental rheumatology.

[11]  T. Southwood,et al.  Incidence of Henoch-Schonlein purpura, Kawasaki disease, and rare vasculitides in children of different ethnic origins , 2002, The Lancet.

[12]  E. Thervet,et al.  Henoch-Schönlein Purpura in adults: outcome and prognostic factors. , 2002, Journal of the American Society of Nephrology : JASN.

[13]  A. Gibofsky American College of Rheumatology. , 2002, Journal of the Medical Association of Georgia.

[14]  J. Llorca,et al.  Henoch-Schönlein Purpura in Children from Northwestern Spain: A 20-Year Epidemiologic and Clinical Study , 2001, Medicine.

[15]  P. Rieu,et al.  Henoch-Schönlein nephritis in children and adults. Morphological features and clinicopathological correlations. , 1999, Annales de medecine interne.

[16]  V. Rodríguez-Valverde,et al.  Henoch-Schönlein purpura in adulthood and childhood: two different expressions of the same syndrome. , 1997, Arthritis and rheumatism.

[17]  O. Yamamoto,et al.  An aged patient with Henoch-Schönlein purpura nephritis: a case report and review of the literature. , 1992, Internal medicine.