Hematuria and palpable purpura, is it a case of IgA vasculit
The following case has been published in the journal Annals of Emergency Medicine.

A 55-year-old man with a history of hypertension presented to the emergency department (ED) with complaints of a bilateral lower extremity rash for 1 week (Figures 1 and 2). The patient initially noticed a spotted rash around his sock line, which he attributed to “ringworm.”

During the course of the next week, the lesions spread proximally and coalesced into a palpable rash. He denied preceding illness or use of any new soap or detergents. On review of systems, he did note a red tint to his urine but denied abdominal or joint pain. Laboratory analysis confirmed the presence of hematuria and revealed normal renal function.

Henoch-Schönlein’s purpura was suspected with hematuria and palpable purpura, although his renal function during his ED visit was normal.

The patient was referred to rheumatology and dermatology, where skin biopsy confirmed immunoglobulin A–mediated vasculitis. At subsequent visits, the rash had nearly resolved and the patient’s renal function remained normal.

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