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IgA Vasculitis — RACP Adult Medicine MCQ

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ModerateRheumatologyIgA VasculitisRACP Adult Medicine

A 38-year-old man presents with a palpable purpuric rash on the lower extremities, arthralgia, and abdominal pain. Urinalysis shows microscopic haematuria and proteinuria. Serum IgA is elevated. Kidney biopsy shows mesangial IgA deposition. What is the most likely diagnosis?

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Correct answer: E — IgA vasculitis (Henoch-Schönlein purpura)

Palpable purpura, arthralgia, abdominal pain (GI vasculitis), and renal involvement with mesangial IgA deposition is classic IgA vasculitis (HSP). Although more common in children, it occurs in adults where renal involvement tends to be more severe. Treatment is supportive for mild disease; corticosteroids and immunosuppression for severe nephritis.

Reference: EULAR – 2024 – Small Vessel Vasculitis; KDIGO 2021