2022 Volume 13 Issue 1 Pages 37-42
IgA vasculitis (IgAV) is a relatively common vasculitis syndrome in children, and recurrence of this condition is not uncommon. We report a case of acute appendicitis associated with IgAV recurrence which improved in response to conservative treatment. A 6-year-old boy complained of abdominal pain and purpura on both lower extremities. He was admitted to our hospital on the 7th day after the onset of symptoms due to exacerbation of the condition and was diagnosed with IgAV. Administration of prednisolone (PSL) 1 mg/kg/day rapidly improved symptoms and the patient was discharged on the 15th day after symptom onset. PSL was gradually discontinued and the patient did not report abdominal pain or purpura, but 11 days later, he visited the emergency department because of fever and upper and right lower abdominal pain (no purpura). He was admitted to the hospital; ultrasonography revealed acute appendicitis due to swelling of the appendix. Conservative treatment with cefmetazole (CMZ) improved the symptoms of appendicitis, but upper abdominal pain persisted and purpura appeared on both extremities. We considered these symptoms to be from IgAV recurrence. His symptoms improved rapidly with PSL, and the subsequent course was good. Although it is rare for IgAV to be complicated by acute appendicitis, appropriate treatment should be determined by performing imaging tests, such as ultrasonography or computed tomography, in addition to clinical findings.
