# Mycophenolate Mofetil as a Therapeutic Option in Refractory Immunoglobulin A Vasculitis: A Report of Two Atypical Cases

## TL;DR

This paper reports two rare cases of IgA vasculitis that improved with treatment using corticosteroids and mycophenolate mofetil.

## Contribution

The study suggests mycophenolate mofetil could be an effective treatment for refractory IgA vasculitis.

## Key findings

- Two patients with severe IgA vasculitis showed significant improvement with mycophenolate mofetil and corticosteroids.
- Mycophenolate mofetil was effective in cases refractory to conventional therapies like IVIG and high-dose steroids.
- The results suggest MMF may serve as an adjunctive therapy for severe or treatment-resistant IgA vasculitis.

## Abstract

We report two rare and challenging cases of Immunoglobulin A (IgA) vasculitis with atypical clinical presentations, both of which responded favorably to treatment with corticosteroids and mycophenolate mofetil (MMF). The first case involved a patient with pulmonary-renal syndrome, a rare manifestation of IgA vasculitis. The second case presented predominantly with severe gastrointestinal manifestations and was refractory to conventional therapies, including high-dose corticosteroids, intravenous immunoglobulin (IVIG), and cryoprecipitate. In both cases, the introduction of MMF alongside corticosteroids resulted in significant clinical improvement and eventual remission. These cases underscore the potential role of MMF as an adjunctive therapy in managing severe or refractory forms of IgA vasculitis, particularly when standard treatment options prove insufficient.