Alcohol-Associated Immunoglobulin A Vasculitis: A Case Report and Review of the Literature

Abstract

Immunoglobulin A (IgA)-mediated leukocytoclastic vasculitis is a cutaneous small-vessel vasculitis characterized by skin findings of palpable purpura. It may occur secondary to infections, neoplasms, drugs, and systemic conditions, although it is most commonly idiopathic. A known, but rare, trigger for IgA vasculitis is alcohol consumption. We present a case of a man with IgA vasculitis associated with alcohol use and review the literature on alcohol-associated vasculitis. Although rarely reported, alcohol-associated IgA vasculitis is an important entity to consider for appropriate diagnosis and management of such patients.

IgA vasculitis triggered by alcohol consumption in a 51-year-old man: A case report

“…Only 4 biopsy-proven cases of alcohol as a trigger for IgA vasculitis in adults have been reported. 2 , 3 , 4 , 5 In one of these cases, the patient only developed the exanthem secondary to the consumption of alcohol with hops. 5 Another case reported that the vasculitis flared with the consumption of wine and vinegar.…”

“… 2 , 3 , 4 , 5 In one of these cases, the patient only developed the exanthem secondary to the consumption of alcohol with hops. 5 Another case reported that the vasculitis flared with the consumption of wine and vinegar. 4 One report found beer to be the trigger.…”

“… 1 While rare, there have been documented cases reporting alcohol consumption as a trigger for IgA vasculitis in adults. 2 , 3 , 4 , 5 …”

Eosinophilic granulomatosis with polyangiitis: Cutaneous clinical and histopathologic differential diagnosis

“…37 IgA vasculitis was formerly known as Henoch-Schönlein purpura and most commonly occurs in children, although adult cases have been reported. 35,37 Histopathologically, patients with IgA-associated vasculitis will most often show a superficial dermal infiltrate of predominately neutrophils (as opposed to an eosinophil predominant process involving the deep dermis and subcutaneous vasculature in EGPA), although the entire dermis may be involved on occasion. 22 IgA vasculitis may affect arterioles, capillaries and, above all, venules; it is associated with (isolated or predominant) IgA deposition involving vessel walls.…”

“…Immunoglobulin A (IgA)‐mediated leukocytoclastic vasculitis is a cutaneous small vessel vasculitis (Figure 2E) characterized by palpable purpura on the bilateral lower extremities and granular deposition of IgA immune complexes in dermal vessels walls by DIF (Figure 2F). 37 IgA vasculitis was formerly known as Henoch‐Schönlein purpura and most commonly occurs in children, although adult cases have been reported 35,37 . Histopathologically, patients with IgA‐associated vasculitis will most often show a superficial dermal infiltrate of predominately neutrophils (as opposed to an eosinophil predominant process involving the deep dermis and subcutaneous vasculature in EGPA), although the entire dermis may be involved on occasion 22 .…”