A clinical case of a complicated course of immunoglobulin A vasculitis with long-term nephritis: peculiarities of treatment

Immunoglobulin A vasculitis is the most common systemic in children. Its course can be mild, involving only skin and not requiring medical intervention, as well severe, recurrent, long-lasting — when gastrointestinal tract kidneys are involved. Nephritis often cause disease severity, although abdominal pain usually affects well-being of child. We present a clinical case immunoglobulin 6-year-old girl who had an acute onset with severe syndrome vomiting that preceded appearance rash. The use direct anticoagulants led to gastric bleeding. Treatment corticosteroids positive effect on syndrome, but did prevent development kidney injury hematuria moderate proteinuria. stable persistent course. Recurrences rashes were observed. Long-term corticosteroid therapy renoprotection using angiotensin-converting enzyme inhibitors allowed partial control disease. presented confirms long, frequent relapses manifestations, transformation into glomerulonephritis, even presence Skin manifestations nephritis cannot always completely controlled by first-line therapy, which requires balanced decision regarding escalation treatment, taking account biopsy data, function, severity Renoprotection or angiotensin receptor blockers secondary injury. implementation European guidelines treatment vasculitis, including associated nephritis, will allow unifying approaches patient management, detecting damage timely carrying out appropriate measures.