Henoch-Schönlein Purpura Associated with Giardiasis in an 18-Year-Old: A Case Report from Mogadishu, Somalia

Yassir Balla,1 Abyan Hassan Dimbil,1,2 Abdifatah Abdullahi Jalei,2,3 Abdifetah Ibrahim Omar,2 Saleh Abdulkadir Saeed Al-Duais4,5 1Department of Internal Medicine, Hodan Hospital, Mogadishu, Somalia; 2Department of Medicine, Faculty of Medicine and Health Sciences, Jamhuriya University, Mogadishu, Somalia; 3Department of Laboratory, Hodan Hospital, Mogadishu, Somalia; 4Department of Pathology, Faculty of Medicine and Health Sciences, SIMAD University, Mogadishu, Somalia; 5Sahan Pathology Labs, Mogadishu, SomaliaCorrespondence: Abyan Hassan Dimbil, Department of Internal Medicine, Hodan Hospital, Mogadishu, Somalia, Email [email protected]: Henoch-Schönlein Purpura (HSP), also known as IgA vasculitis (IgAV), is a common childhood vasculitis that frequently involves the gastrointestinal tract. Its occurrence in adults, particularly in association with Giardia lamblia infection, is exceptionally rare.Case Presentation: We report the case of an 18-year-old female, who presented with severe abdominal pain, hematemesis, and a palpable purpuric rash on her lower limbs. Investigations revealed leukocytosis (WBC: 15.5× 103/μL), microscopic hematuria, and elevated serum IgA (3.5 g/L). An upper gastrointestinal endoscopy showed diffuse hemorrhagic mucosa consistent with vasculitis. Stool microscopy identified Giardia lamblia trophozoites. A diagnosed of IgA vasculitis with severe gastrointestinal involvement and concurrent giardiasis was established. The patient was treated with intravenous methylprednisolone and metronidazole, resulting in significant clinical improvement.Discussion and conclusion: This case highlights a rare association between IgA vasculitis and an active Giardia lamblia infection, and to our knowledge, is the first such case reported from Somalia. It underscores the presence of IgAV in adults and emphasizes the importance of investigating for co-infections in patients presenting with sever GI symptoms. A comprehensive evaluation is vital for ensuring timely and appropriate management.Keywords: IgA vasculitis, giardia lamblia, henoch-schönlein purpura, autoimmune disease