A 28-year-old man develops palpable purpura on the lower legs 10 days after a streptococcal throat infection. Skin biopsy shows leukocytoclastic vasculitis with IgA deposits on DIF. Which organ must be evaluated first given the systemic implications of this finding?

• A Liver (hepatitis B-associated vasculitis)
• B Lungs (diffuse alveolar haemorrhage)
• C Joints (IgA-associated erosive arthritis)
• D Kidneys (IgA nephropathy/Henoch-Schönlein nephritis) ✓

Explanation

IgA deposition on DIF in leukocytoclastic vasculitis in a young patient following an upper respiratory infection is diagnostic of IgA vasculitis (Henoch-Schönlein purpura). The most important systemic involvement is IgA nephropathy (Henoch-Schönlein nephritis), which can lead to renal failure; urinalysis for haematuria/proteinuria and renal function assessment are the priority evaluations. Renal involvement determines prognosis and need for immunosuppression.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.