Glycine/analogs & derivatives* ; Humans ; Vasculitis, Leukocytoclastic, Cutaneous

No abstract available.
Vasculitis, Leukocytoclastic, Cutaneous*

Systemic vasculitis involving the lung is a rare manifestation of myelodysplastic syndrome (MDS), and secondary vasculitis is considered to have poor prognosis. A 44-year-old man presented with fever and dyspnea of 1 month duration. A chest radiograph revealed bilateral multiple wedge shaped consolidations. In addition, the results of a percutaneous needle biopsy for non-resolving pneumonia were compatible with pulmonary vasculitis. Bone marrow biopsy was performed due to the persistence of unexplained anemia and the patient was diagnosed with MDS. We reported a case of secondary vasculitis presenting as non-resolving pneumonia, later diagnosed as paraneoplastic syndrome of undiagnosed MDS. The cytopenia and vasculitis improved after a short course of glucocorticoid treatment, and there was no recurrence despite the progression of underlying MDS.
Adult ; Anemia ; Biopsy ; Biopsy, Needle ; Bone Marrow ; Dyspnea ; Fever ; Humans ; Lung ; Myelodysplastic Syndromes* ; Paraneoplastic Syndromes ; Pneumonia ; Prognosis ; Radiography, Thoracic ; Recurrence ; Systemic Vasculitis ; Vasculitis* ; Vasculitis, Leukocytoclastic, Cutaneous

Rupture of isolated posterior spinal artery (PSA) aneurysms is a rare cause of subarachnoid hemorrhage (SAH) that presents unique diagnostic challenges owing to a nuanced clinical presentation. Here, we report on the diagnosis and management of the first known case of an isolated PSA aneurysm in the context of leukocytoclastic vasculitis. A 53-year-old male presented to an outside institution with acute bilateral lower extremity paralysis 9 days after admission for recurrent cellulitis. Early magnetic resonance imaging was read as negative and repeat imaging 15 days after presentation revealed SAH and a compressive spinal subdural hematoma. Angiography identified a PSA aneurysm at T9, as well as other areas suspicious for inflammatory or post-hemorrhagic reactive changes. The patient underwent a multilevel laminectomy for clot evacuation and aneurysm resection to prevent future hemorrhage and to establish a diagnosis. The postoperative course was complicated by medical issues and led to the diagnosis of leukocytoclastic vasculitis that may have predisposed the patient to aneurysm development. Literature review reveals greater mortality for cervical lesions than thoracolumbar lesions and that the presence of meningitic symptoms portents better functional outcome than symptoms of cord compression. The outcome obtained in this case is consistent with outcomes reported in the literature.
Aneurysm* ; Angiography ; Arteries* ; Cellulitis ; Diagnosis ; Hematoma, Subdural, Spinal ; Hemorrhage ; Humans ; Laminectomy ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Mortality ; Paralysis ; Rupture ; Spinal Cord Vascular Diseases ; Subarachnoid Hemorrhage ; Vasculitis* ; Vasculitis, Leukocytoclastic, Cutaneous

Acute Disease ; Chronic Disease ; Humans ; Male ; Middle Aged ; Vasculitis, Leukocytoclastic, Cutaneous ; pathology

Cerebral venous thrombosis (CVT) is quite rare and underlying risk factors are diverse. We describe that 60-year-old man developed CVT after use of cyclosporine. He had suffered from leukocytoclastic vasculitis and urticarial vasculitis. Initial MR venogram revealed thrombosis in superior sagittal sinus, right transverse sinus and sigmoid sinus with multiple cortical and deep collateral veins. Anticoagulation was started and maintained for one year, then follow up MR venogram was normal. We suggest that cyclosporine might increase a risk of CVT.
Colon, Sigmoid ; Cyclosporine ; Follow-Up Studies ; Risk Factors ; Superior Sagittal Sinus ; Thrombosis ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous ; Veins ; Venous Thrombosis

Tumor necrosis factor alpha (TNF-alpha) inhibitors are used widely to treat patients with active rheumatoid arthritis and ankylosing spondylitis (AS). Although various cutaneous reactions can occur as side effects of TNF-alpha inhibitors, systemic vasculitis requiring withdrawal of the agent and immunosuppressive drugs is rare. A 59-year-old male with AS who had been treated with infliximab for 60 months visited us with complaints of palpable purpura on both legs and severe abdominal pain. Abdominal computed tomography showed diffuse wall thickening of the proximal jejunum and ileum and a skin biopsy revealed leukocytoclastic vasculitis. The patient was diagnosed with Henoch-Schonlein purpura (HSP). Infliximab was discontinued and systemic steroid therapy at 0.5 mg/kg resulted in prompt resolution of the HSP. Here, we report the first case of HSP in a patient with AS after infliximab treatment.
Abdominal Pain ; Antibodies, Monoclonal ; Arthritis, Rheumatoid ; Biopsy ; Humans ; Ileum ; Jejunum ; Leg ; Male ; Purpura ; Purpura, Schoenlein-Henoch ; Skin ; Spondylitis, Ankylosing ; Systemic Vasculitis ; Tumor Necrosis Factor-alpha ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous

Methoxy polyethylene glycol-epoetin beta (Mircera(R), Roche), a third-generation erythropoiesis-stimulating agent (ESA) is known as a continuous erythropoietin receptor activator (CERA). In patients with anemia associated with chronic kidney disease (CKD), it is administered intravenously or subcutaneously. Treatment-related adverse events induced by methoxy polyethylene glycol-epoetin beta occurred in 6%. Hypertension, diarrhea and nasopharyngitis were the most commonly reported adverse events. Cutaneous adverse reactions are rarely experienced with methoxy polyethylene glycol-epoetin beta including maculopapular eruption, facial erythema, and tinea pedis. To the best of our knowledge, no cases of leukocytoclastic vasculitis associated with methoxy polyethylene glycol-epoetin beta have ever been published in medical literature. Herein, we report on a case of leukocytoclastic vasulitis induced by methoxy polyethylene glycol-epoetin beta in a patient with anemia associated with chronic kidney disease.
Anemia ; Diarrhea ; Erythema ; Erythropoietin ; Humans ; Hypertension ; Nasopharyngitis ; Polyethylene ; Polyethylene Glycols ; Receptors, Erythropoietin ; Renal Insufficiency, Chronic ; Tinea Pedis ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous

OBJECTIVE: Henoch-Schonlein purpura (HSP) is a systemic vasculitis, characterized by small-vessel leukocytoclastic vasculitis with the deposition of immune complexes containing IgA. It is the most common acute vasculitic disorder affecting children but is relatively uncommon in adults. We investigated the clinical features and factors affecting the prognosis of adult HSP in Korea. METHODS: From 1996 to 2011 seventy patients over 15 years of age with HSP were retrospectively analyzed. RESULTS: Thirty eight patients (54.3%) were female and the age at disease onset ranged from 15 to 75 years (35.0+/-15.8 years). Purpuric skin rash was observed in all patients and arthralgia was present in 34 patients (48.6%). GI symptoms and kidney involvements were observed in 28 patients (40.0%) and 34 patients (48.6%), respectively. Complete remission was achieved in 46 patients (65.7%). The remission group showed a lower incidence of hematochezia (p=0.044), hematuria (p=0.008), and proteinuria (p=0.011) at diagnosis than the no remission group. About 10% of adult HSP patient progressed to chronic kidney disease (CKD), which showed higher a incidence of nephrotic range proteinuria. Only nephrotic range proteinuria at diagnosis was a significant risk factor for CKD (OR=16.7, p=0.008, 95% CI=2.1~133.1). CONCLUSION: Hematochezia, hematuria and proteinuria at the diagnosis of HSP are important prognostic factors in predicting remission. In addition, HSP patients with nephrotic range proteinuria at diagnosis have an increased risk of renal failure.
Adult ; Antigen-Antibody Complex ; Arthralgia ; Child ; Exanthema ; Female ; Gastrointestinal Hemorrhage ; Hematuria ; Humans ; Immunoglobulin A ; Incidence ; Kidney ; Korea ; Prognosis ; Proteinuria ; Purpura, Schoenlein-Henoch ; Renal Insufficiency ; Renal Insufficiency, Chronic ; Retrospective Studies ; Risk Factors ; Systemic Vasculitis ; Vasculitis ; Vasculitis, Leukocytoclastic, Cutaneous

Leukocytoclastic vasculitis (LCV) usually presents palpable purpura characterized by inflammation of vessel walls and fragmentation of nuclei. Various conditions can cause LCV, and it can be induced by influenza A virus infection. We report a 2-yr-old Korean girl who presented palpable purpuric and hemorrhagic lesions with fever. She was diagnosed as LCV by skin biopsy, and influenza A virus was isolated from nasopharyngeal swab. She was treated with oseltamivir (Tamiflu(R)) and prednisolone with dramatic effect of vasculitis and fever.
Anti-Inflammatory Agents/therapeutic use ; Antiviral Agents/therapeutic use ; Child, Preschool ; Female ; Fever/etiology ; Humans ; Influenza A virus/*genetics/isolation & purification ; Influenza, Human/*complications/drug therapy/virology ; Nasopharynx/virology ; Oseltamivir/therapeutic use ; Prednisolone/therapeutic use ; Reverse Transcriptase Polymerase Chain Reaction ; Skin/pathology ; Vasculitis, Leukocytoclastic, Cutaneous/*diagnosis/drug therapy/etiology