{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T15:31:40Z","timestamp":1788535900577,"version":"build-2803163510"},"reference-count":12,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medical Case Reports"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>Dipeptidyl peptidase-4 inhibitors are oral antihyperglycemic medications often used as adjuncts to other antidiabetic agents to treat type 2 diabetes mellitus. Henoch\u2013Sch\u00f6nlein purpura, also known as ImmunoglobulinA (IgA) vasculitis, is a form of IgA-mediated leukocytoclastic vasculitis, which is rarely reported in adults. Herein, we report the case of a 52-year-old male with type 2 diabetes mellitus who presented with petechiae, ecchymoses, and palpable purpura below the knees bilaterally after starting sitagliptin, a dipeptidyl peptidase-4 inhibitor. A punch biopsy for direct immunofluorescence showed granular Immunoglobulin A, M, and complement 3 in vessel walls, suggestive of Henoch\u2013Sch\u00f6nlein purpura. Sitagliptin was discontinued, and the patient was treated with celecoxib, colchicine, and cefadroxil for wound infection. Three months after initial presentation, brown hyperpigmentation was appreciated, suggestive of post-inflammatory changes and resolution of the lesions. However, urinalysis revealed new 0.3\u2009g\/L protein. Overall, this case highlights a new potential association of dipeptidyl peptidase-4 inhibitors with Henoch\u2013Sch\u00f6nlein purpura, which may have systemic consequences.<\/jats:p>","DOI":"10.1177\/2050313x251400839","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T14:11:19Z","timestamp":1764857479000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Henoch\u2013Sch\u00f6nlein purpura induced by sitagliptin: A case report"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6442-2349","authenticated-orcid":false,"given":"Alexa","family":"Moschella","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of Ottawa, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5967-2539","authenticated-orcid":false,"given":"Carly","family":"Kirshen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Ottawa, ON, Canada"},{"name":"Division of Dermatology, Department of Medicine, The Ottawa Hospital, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,12,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)02317-1"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc06-0706"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.4274\/jarem.galenos.2018.2019"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40842-024-00165-w"},{"key":"e_1_3_3_6_2","volume-title":"StatPearls","author":"Baigrie D","year":"2025","unstructured":"Baigrie D, Crane JS. Leukocytoclastic vasculitis. In: StatPearls. Treasure Island, FL: StatPearls, 2025."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/1476-7961-9-9"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-2733"},{"issue":"4","key":"e_1_3_3_9_2","first-page":"235","article-title":"Vildagliptin induced cutaneous leukocytoclastic vasculitis: a case report","volume":"6","author":"Sayin S","year":"2017","unstructured":"Sayin S, Omeroglu E, Bilgin S. Vildagliptin induced cutaneous leukocytoclastic vasculitis: a case report. Med Sci Int Med J 2017; 6(4): 235\u2013237.","journal-title":"Med Sci Int Med J"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2020.102707"},{"issue":"4","key":"e_1_3_3_11_2","first-page":"199","article-title":"Sitagliptin kullan\u0131m\u0131na ba\u011fl\u0131 geli\u015fen k\u00fctan\u00f6z l\u00f6kositoklastik vask\u00fclit: olgu sunumu","volume":"4","author":"U\u00e7an B","year":"2012","unstructured":"U\u00e7an B, Topalo\u011flu O, \u00c7akal E, et al. Sitagliptin kullan\u0131m\u0131na ba\u011fl\u0131 geli\u015fen k\u00fctan\u00f6z l\u00f6kositoklastik vask\u00fclit: olgu sunumu. Ortado\u011fu Tip Dergisi 2012; 4(4): 199\u2013201.","journal-title":"Ortado\u011fu Tip Dergisi"},{"key":"e_1_3_3_12_2","unstructured":"Kaur A Patil T Patel M et al. Alogliptin induced leukocytoclastic vasculitis: a case report. In: American college of clinical pharmacy virtual poster symposium 24 May 2022. https:\/\/accp.confex.com\/accp\/2022vp\/meetingapp.cgi\/Paper\/59627 (accessed 18 February 2025)."},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdin.2022.05.004"}],"container-title":["Sage Open Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X251400839","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2050313X251400839","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X251400839","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T19:21:47Z","timestamp":1765135307000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2050313X251400839"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":12,"alternative-id":["10.1177\/2050313X251400839"],"URL":"https:\/\/doi.org\/10.1177\/2050313x251400839","relation":{},"ISSN":["2050-313X","2050-313X"],"issn-type":[{"value":"2050-313X","type":"print"},{"value":"2050-313X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]},"article-number":"2050313X251400839"}}