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Immunoglobulin A vasculitis (IgAV), formerly Henoch–Schonlein purpura vasculitis, is a vasculitis commonly seen in children and ¨ only rarely described in adult patients. IgAV can present as arthralgia, rash, discolored urine, acute kidney injury, and gastrointestinal symptoms. We present a case of a 56-year-old man who presented with 1 month of worsening abdominal pain followed by a bilateral lower extremity rash. Laboratory evaluation indicated an acute kidney injury. Computed tomography and colonoscopy revealed terminal ileitis while kidney biopsy confirmed a diagnosis of IgAV. | Adult-onset immunoglobulin a vasculitis