Skin as the First Clue: A Case Report of Immunoglobin A (IgA) Vasculitis

We report the case of a seven-year-old female patient who attended an unscheduled primary care consultation due to palpable purpura of the lower limbs without signs of systemic involvement.Symptoms began two weeks after streptococcal acute tonsillitis treated with intramuscular penicillin.Given the potentially serious etiologies of purpura in paediatric patients, she was referred to the paediatric emergency department to exclude severe infectious and hematologic conditions and to monitor for possible complications.Initial laboratory evaluation revealed no hematologic, inflammatory or renal abnormalities and the patient was discharged with a presumed diagnosis of isolated purpura and scheduled for clinical surveillance.However, at the subsequent reassessment, she developed arthralgia, peripheral oedema, and abdominal pain, leading to a diagnosis of immunoglobulin A vasculitis and illustrating the dynamic and sequential evolution of the disease.Clinical course was favourable under supportive treatment and specialised follow-up, without evidence of renal involvement throughout the observation period.This case highlights the importance of early recognition of palpable purpura in primary care settings, even when initially isolated, as well as timely referral for exclusion of severe disease and appropriate monitoring for complications with potential prognostic impact, particularly renal involvement.