IgA-Associated Vasculitis Presenting With Acute Abdominal Syndrome in an Older Patient.

BACKGROUND IgA-associated vasculitis (IgAV), although relatively uncommon in adults, is frequently associated with increased vasculitis severity. Sudden abdominal pain and bloody diarrhea are among the usual manifestations of IgAV in children. In older patients, clinical manifestations of the disease may be typical, but advanced age and comorbidities can make the final diagnosis unexpected. CASE REPORT A 67-year-old man with multiple underlying medical conditions, including diabetes mellitus and arterial hypertension, was admitted with acute abdominal pain. Baseline evaluation revealed venous ischemic necrosis of the ileum and concurrent acute kidney injury. Given the patient's age and diabetic status, an atherogenic etiology was initially considered. Further diagnostic investigation, including renal biopsy, identified features consistent with IgAV. The patient's clinical course was complicated by simultaneous gastrointestinal and renal involvement, highlighting the systemic nature of the vasculitis. CONCLUSIONS Although IgAV is predominantly a pediatric condition, its presentation in older adults is rare and often atypical, commonly mimicking other vascular or ischemic disorders; this pattern may delay diagnosis and appropriate treatment. The present case emphasizes the need to maintain awareness of IgAV in older patients who present with acute abdominal symptoms, particularly when renal dysfunction is present. Advanced age and diabetic status are associated with increased severity and worse renal outcomes, underscoring the need for thorough evaluation and close monitoring. This report contributes to the limited literature on IgAV in older patients; it illustrates the diagnostic and therapeutic challenges in this population.