Clinical Manifestations of IgA Vasculitis
IgA vasculitis is a multi-system disease with a range of clinical manifestations. Recognizing the characteristic signs and symptoms is essential for early diagnosis and effective management. The disease primarily involves the skin, joints, gastrointestinal tract, and kidneys, producing a combination of acute and sometimes chronic symptoms.
The hallmark feature is palpable purpura, typically seen on the lower extremities and buttocks. These purplish spots are raised and non-blanching, indicating bleeding under the skin. Unlike simple bruising, palpable purpura is firm and often tender, helping distinguish IgA vasculitis from other dermatological conditions. In some cases, lesions may spread to the arms or trunk, but lower body involvement is most common.
Joint symptoms frequently accompany the rash, particularly in the knees and ankles. Patients experience swelling, stiffness, and pain, which can temporarily limit mobility. Although joint symptoms are usually self-limiting, they can be severe enough to interfere with daily activities, especially in children and active adults.
Gastrointestinal manifestations include abdominal pain, nausea, vomiting, and, in severe cases, gastrointestinal bleeding. The inflammation of small intestinal blood vessels can lead to edema, cramping, and, rarely, complications such as intussusception or bowel ischemia. Close monitoring of gastrointestinal symptoms is critical, as early intervention can prevent life-threatening complications.
Renal involvement, or IgA nephropathy, occurs in some patients and can manifest as hematuria (blood in the urine) or proteinuria (protein in the urine). Adults are more likely than children to develop significant kidney involvement, which may lead to chronic kidney disease if not addressed. Regular urinalysis and kidney function tests are essential for early detection and ongoing monitoring.
Other less common manifestations include mild fever, fatigue, and edema of the hands or feet. Symptoms can vary in intensity and may appear sequentially, which sometimes complicates early diagnosis.
Understanding the spectrum of IgA vasculitis symptoms helps clinicians differentiate it from other vasculitides, autoimmune disorders, or gastrointestinal diseases. Comprehensive evaluation—combining clinical observation, laboratory testing, and sometimes biopsy—supports accurate diagnosis, timely intervention, and monitoring for potential complications.