Cutaneous Vasculitis After Renal Transplantation: A Case Report

Rau, Stefanie; Wollenberg, Andreas; Weiß, Max; Fischereder, Michael; Schönermarck, Ulf

doi:10.1016/j.transproceed.2012.04.037

Cited by 5 publications

(6 citation statements)

References 4 publications

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“…Skin biopsy showed findings consistent with IgAV, and subsequent kidney biopsy revealed evidence of active IgA nephropathy but no signs of allograft rejection. 8 The second case was a 49-year-old woman of South East Asian ethnicity, 8 years post-living-related donor kidney transplant for biopsy-proven IgA nephropathy, with no previous history of IgA vasculitis. Ten days after receiving the annual influenza vaccine, she presented with a palpable purpuric rash involving the limbs.…”

Section: Discussionmentioning

confidence: 99%

“…The choice of immunosuppressive regimens post–renal transplant does not alter the likelihood of recurrence of IgAN. 8 The Supportive Versus Immunosuppressive Therapy of Progressive IgA nephropathy (STOP IgAN) trial aims to assess the efficacy of immunosuppressive treatments versus supportive treatment, which includes blood pressure control, appropriate treatment of the metabolic syndrome, and diet restrictions, 9 to establish a standardized treatment protocol for IgA nephropathy.…”

Section: Discussionmentioning

confidence: 99%

“…Skin biopsy showed findings consistent with IgAV, and subsequent kidney biopsy revealed evidence of active IgA nephropathy but no signs of allograft rejection. 8…”

Section: Discussionmentioning

confidence: 99%

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IgA Cutaneous Purpura Post–Renal Transplantation in a Patient With Long-Standing IgA Nephropathy

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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IgA Cutaneous Purpura Post–Renal Transplantation in a Patient With Long-Standing IgA Nephropathy

et al. 2015

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“…Histologically, vascular dilatation, erythrosis extravasation, inflammatory infiltration around vascular channels, endothelial swelling, and reactive nuclear changes in the endothelium are defined as vasculopathic reactions. 20,21 Its difference from vasculitis is the absence of fibrin deposition in the vessel wall. Vasculopathic reactions are mainly because of infectious complications or drug-related adverse events, and they also may indicate the recurrence of the original disease.…”

Section: Discussionmentioning

confidence: 99%

“…Vasculopathic reactions are mainly because of infectious complications or drug-related adverse events, and they also may indicate the recurrence of the original disease. 20 In the literature, few case reports of cutaneous vasculitis have been reported after transplant. 20,22 In our study, we had 4 skin biopsies including vasculopathic lesions, and in all of them, additional to histologic findings of vasculopathy, eosinophil-leukocyte infiltration was seen, and this finding let us think that these reactions were drug-related adverse events.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2014

Exp Clin Transplant

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Objectives: This study sought to analyze the incidence and risk factors of skin complications in liver transplant recipients. Materials and Methods: Patients with skin biopsies were selected from 408 liver transplant recipients from January 1990 to December 2012 at Baskent University in Ankara, Turkey. Demographic and clinical findings including age, sex, primary liver disease, immunosuppressive therapy, and the time between transplant and cutaneous lesions were examined. Results: There were 38 patients who had skin biopsy after liver transplantation. The mean age at transplantation was 30.5 years. The primary liver disease was hepatocellular carcinoma seconder to viral hepatitis in 15 patients, Wilson disease in 7 patients, criptogenic cirrhosis in 3, familial hypercholesterolemia in 3 patients, and 1 each patients of Byler disease, Caroli disease, tyrosinemia, Budd-Chiari sendrom, congenital hepatic fibrosis, alcholic cirrhosis, and biliar atresia. The primary disease in 3 patients were unknown. The histologic diagnosis included precancerous and cancerous lesions (n=4), infectious diseases (n=4); xanthomatous lesions (n=4); vasculopathic lesions (n=4); melanocytic lesions (n=4); benign adnexial tumors (n=2); skin atrophy (n=2); calcinosis cutis (n=2), keratinous cyst (n=2), neutrophilic dermatosis (n=2), perivascular dermatitis (n=2) and miscellaneous lesions (n=6). Conclusions:We presented the cutaneous manifestations in liver transplant recipients. The most common skin lesion in these patients were precancerous and cancerous lesions, infectious, xanthomatous, and melanocytic lesions. The findings emphasize the importance of dermatologic screening in these patients that can provide early diagnosis and a better quality of life.

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Mycophenolate mofetil/tacrolimus

2013

Reactions Weekly

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A 69-year-old man developed Henoch-Schoenlein purpura during immunosuppressive therapy with mycophenolate mofetil and tacrolimus [routes and dosages not stated; duration of treatments to reaction onset not clearly stated].The man had a history of IgA nephropathy and had undergone renal transplantation. His initial immunosuppressive regimen had consisted of mycophenolate mofetil, tacrolimus, and steroids [drugs not specified]. His steroids had been discontinued 6 months after his transplant. He was hospitalised 21 months after his transplant with palpable purpura of his limbs, diffuse arthralgias, and skin ulcerations. Laboratory tests revealed the following: serum creatinine 2.1 mg/dL (184 µmol/L estimated glomerular filtration rate 34 mL/min), WBC 12.4 g/L, thrombocytes 366 g/L, and CRP 22.6 mg/dL. Urine analysis revealed haematuria and proteinuria. Histological analysis of a skin biopsy from his right lower limb revealed leucocytoclastic vasculitis with perivascular lymphohistiocytic infiltrates. Direct immunofluorescence showed deposition of IgA, complement C3, and fibrinogen.The man was treated with prednisolone. His skin lesions rapidly improved and he was discharged after 13 days. Four weeks later, his skin lesions were hardly visible, his serum creatinine was stable at 1.5 mg/dL, and neither proteinuria nor haematuria were detectable. His immunosuppressive therapy was continued with mycophenolate mofetil, tacrolimus, and prednisolone. He experienced no further signs of cutaneous vasculitis.Author comment: "Noteably, the cutaneous vasculitis, classified as [Henoch-Schoenlein purpura] by skin biopsy, developed under immunosuppression with tacrolimus and mycophenolate mofetil." Rau S, et al. Cutaneous vasculitis after renal transplantation: A case report.

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Cutaneous Vasculitis After Renal Transplantation: A Case Report

Cited by 5 publications

References 4 publications

IgA Cutaneous Purpura Post–Renal Transplantation in a Patient With Long-Standing IgA Nephropathy

IgA Cutaneous Purpura Post–Renal Transplantation in a Patient With Long-Standing IgA Nephropathy

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Mycophenolate mofetil/tacrolimus

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