Nasal Manifestations of Immunoglobulin A (IgA) Vasculitis in an Adolescent Patient: A Case Report.

Immunoglobulin A vasculitis (IgAV), formerly known as Henoch-Schönlein purpura, is a complex immune-mediated vasculitis characterized by the involvement of small blood vessels in various organ systems.  We describe the case of a 14-year-old girl who developed a non-typical manifestation of vasculitis with notable rhinological features. The patient presented with a vasculitis-type rash on the hands and lower extremities bilaterally and arthralgia, while she also complained about intense nasal congestion. The laboratory results were atypical for a specific disorder, and the skin and nasal mucosa biopsies were not diagnostic. Since the patient presented with microscopic hematuria, she underwent a kidney biopsy that confirmed the diagnosis of IgAV with nephritis. The patient was maintained on long-term therapy with corticosteroids, azathioprine, and hydroxychloroquine and showed improvement in symptoms. The aim of this case report is to highlight the atypical presentation of IgAV, particularly its rhinologic manifestations, which are infrequently reported in the literature. In addition, this report emphasizes the importance of long-term follow-up in such patients, as the diagnosis can be challenging.