A case of severe strongyloidiasis complicating immunosuppressive therapy initiated for IgA vasculitis

IgA vasculitis (IgAV) and Strongyloides stercoralis infection may both present with abdominal pain and purpura; however, glucocorticoid, the treatment for IgAV, is a major risk factor for S. stercoralis hyperinfection syndrome and disseminated strongyloidiasis. To date, only 2 cases of IgAV with concurrent S. stercoralis infection have been reported globally, both in children. We report a 72-year-old man presenting with abdominal pain and purpura. Diagnosed with IgAV during this admission, he received glucocorticoid therapy. However, the patient’s condition did not improve as expected. Subsequently, S. stercoralis was detected in the patient's sputum and stool. We report the first adult case of IgAV with concurrent S. stercoralis infection, highlighting the importance of screening patients with IgAV for strongyloidiasis before initiating immunosuppressive therapy.