Axial Spondyloarthritis and IgA Vasculitis: Rare Association or Just Not Recognized

Axial spondyloarthritis (axSpA) also known as ankylosing spondylitis is an inflammatory arthritis involving the spineand sacroiliac joints with extra-musculoskeletal manifestations most commonly involving the eye, gut and skin. Otherorgan involvement can occur including cardiac (aortic insufficiency), lungs (upper-lobe predominant interstitial fibrosis)and kidneys (nephritic syndrome). Immunoglobulin A vasculitis (IgAV) formally known as Henoch-Schönlein purpura[HSP] is the most common form of systemic vasculitis in children and is often self-limited. The disease is characterizedby palpable purpura, arthritis or arthralgia, abdominal pain as well as kidney involvement. It has been proposed thatthere is a selective increase of serum IgA levels during active inflammatory disease of axSpA. Here we explore a case of agentleman who presents with IgA vasculitis and was found to have a new diagnosis of axSpA. We have also reviewed thecurrent literature of cases of IgAV on the background of patients with ankylosing spondylitis.