From the Research
The treatment for IgA vasculitis should be tailored to the severity of symptoms and organ involvement, with glucocorticoids being the first-line therapy for severe manifestations, especially in adults, as supported by the most recent study 1. The management of IgA vasculitis depends on the severity of symptoms, with mild cases often requiring only supportive care, while severe cases need more aggressive intervention.
- For mild cases with minimal symptoms, treatment includes adequate hydration, rest, and over-the-counter pain relievers like acetaminophen or NSAIDs such as ibuprofen for joint pain and fever.
- Patients with more severe symptoms may require corticosteroids, typically oral prednisone at 1-2 mg/kg/day for 1-2 weeks followed by a gradual taper over several weeks.
- For severe cases with significant kidney involvement, high-dose pulse methylprednisolone (30 mg/kg/day for 3 days) may be used, followed by oral prednisone, as suggested by 2.
- In cases with severe nephritis or other organ complications, immunosuppressive medications like cyclophosphamide, azathioprine, or mycophenolate mofetil might be added, with rituximab showing promise in reducing relapse frequency and achieving long-term remission, as noted in 1.
- Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers may be prescribed to manage hypertension and protect kidney function, highlighting the importance of monitoring blood pressure, urinalysis, and kidney function during and after treatment, as kidney complications can develop weeks after initial symptoms appear, as discussed in 3 and 4. IgA vasculitis is caused by abnormal immune complex deposition in small blood vessels, which explains why immunosuppressive treatments are effective in controlling the inflammatory response, as explained in 5. The role of various immunomodulatory therapies, such as calcineurin inhibitors and mycophenolate mofetil, remains promising, while other potential therapies with encouraging results require further research, as concluded in 1.