IgA vasculitis and acute hemorrhagic edema of infancy: a comparative analysis of two case reports

Brenda Maria Toro, Department of Pediatrics, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
Miguel Bernardo, Department of Pediatrics, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
Bárbara Matos Aguas, Department of Pediatrics, Hospital Santa Maria, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal

Introduction: Acute hemorrhagic edema of infancy (AHEI) is sometimes considered a milder variant of immunoglobulin A vasculitis (IgAV). This paper presents two clinical cases, aiming to explore the overlaps and differences between these two pathologies. Case report: A four-year-old initially presented with odynophagia, fever, and arthralgia. The diagnosis of IgAV was established following the development of purpura. A nontoxic five-month-old girl, initially diagnosed with viral exanthema, presented with fever, mild respiratory symptoms, and a maculopapular rash on the torso. Gradual progression to purpuric lesions and acral edema led to the diagnosis of AHEI. Discussion: While IgAV and AHEI share some clinical and histological features, their immunofluorescence patterns differ significantly. IgA deposition is observed in nearly 100% of IgAV cases but only in 10–35% of AHEI cases. This disparity may be attributed to the natural immaturity of the immune system in younger infants, potentially explaining the differences between these two diseases.

Keywords: Iga vasculitis. Henoch-Schöenlein purpura. Acute hemorrhagic edema. Pediatrics. Purpura. Leukocytoclastic vasculitis.