Adult IgA vasculitis characterized by gastrointestinal involvement misdiagnosed as hemorrhagic enteritis: A case report and literature review

Objective To investigate the clinical manifestations of IgA vasculitis and explore the causes of its misdiagnosis．Methods Clinical data about one case of IgA vasculitis misdiagnosed as hemorrhagic enteritis in June 2016 in Chinese PLA General Hospital were analyzed retrospectively． Results A 56-year-old male patient was admitted to the department of dermatology of a hospital because of purpura on lower limbs． During treatment, severe abdominal pain developed abruptly, and the patients was suspected as acute appendicitis． Then he was transferred to the department of general surgery for appendectomy． After operation, he was diagnosed as hemorrhagic enteritis while the abdominal pain didn't relieved． Then, exploratory laparotomy and ileostomy were performed and the abdominal pain didn't relieved yet． He was transferred to our hospital and diagnosed as IgA vasculitis after a consultation with rheumatologists． After treated by high-dose glucocorticoid, immunoglobulin and rituximab, the patient's clinical conditions improved gradually． Conclusion IgA vasculitis is less common in adults． When gastrointestinal involvement is the initial or main symptom in patients with IgA vasculitis, it could be easily misdiagnosed as surgical emergency, such as hemorrhagic enteritis． To patients suspected of IgA vasculitis, cautious differential diagnosis should be carried out．