IgA Vasculitis with Multiple Large Ulcers and Protracted Healing in an Elderly Woman

Abstract

IgA vasculitis is a type of small vessel vasculitis that is characterized by IgA- immune deposits, often involves the skin,gastrointestinal tract, and glomerulus, and frequently causes arthritis and nephritis. In adults and especially in elderly people,IgA vasculitis is more likely to manifest large purpura, ulcerative skin lesions, and chronic renal insufficiency than in children. We describe an 81-year-old female with IgA vasculitis who presented with multiple ulcers on both legs. A direct immunofluorescence analysis revealed the deposition of IgA, IgM and C3 on the vascular wall. Treatment with oral prednisolone was started but it took approximately 3 months for the ulcers to epithelize and the process of recovery from the renal disorder was also protracted. Although thrombus formation in the dermal blood vessels was seen histologically, antiphosphatidylserine/prothrombin autoantibodies were not detected. The protracted healing of the ulcers was thought to be caused by more than one factor such as a secondary infection along with tissue fragility and phlebostasis due to aging.