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Rare case of ankylosing spondylitis complicated by IgA vasculitis
  1. Sangita Kamath1,
  2. Tauheed Ahmed1,
  3. Farah Rana2 and
  4. Ajat Shatru Upadhyay1
  1. 1Department of Medicine, Tata Main Hospital, Jamshedpur, Jharkhand, India
  2. 2Department of Pathology, Tata Main Hospital, Jamshedpur, Jharkhand, India
  1. Correspondence to Dr Tauheed Ahmed; tauheed.90{at}gmail.com

Abstract

Ankylosing spondylosis (AS) is characterised by bilateral sacroiliitis, asymmetric peripheral oligoarthritis, association with the human leucocyte antigen-B27, enthesitis and dactylitis. The association of IgA vasculitis with AS has been documented in few case reports. We present a rare case of a man in his 40s with AS, who presented with fever, bloody loose stools, abdominal pain, lower limb arthritis, palpable purpura over the lower limbs. He subsequently, also developed renal involvement in the form of proteinuria. His skin biopsy showed evidence of leucocytoclastic vasculitis, while renal biopsy showed focal proliferative, necrotising IgA glomerulonephritis. He was thus diagnosed to have Henoch Schonlein purpura with IgA nephropathy in the background of AS. He was treated with steroids and mycophenolate mofetil with resolution of his symptoms.

  • Anklosing spondylitis
  • Vasculitis

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Footnotes

  • Contributors SK and ASU drafted the initial manuscript, performed the relevant literature search and were involved in the management of the patient. FR was involved in the histopathological diagnosis and provided the biopsy photomicrographs. TA was involved in revision and critical review of the manuscript. All authors have read and approved the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.