Diagnóstico e terapêutica precoce de vasculite leucocitoclástica: relato de caso

Bezerra, Alexandre Sacchetti; Polimanti, Afonso César; Oliveira, Rafael Andretti de; Fürst, Rafael Vilhena de Carvalho; Criado, Paulo Ricardo; Corrêa, João Antônio

doi:10.1590/1677-5449.190072

Cited by 4 publications

(3 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Por conseguinte, há uma migração de neutrófilos para região, os quais liberam derivados reativos do oxigênio e enzimas para eliminar antígenos. Dessa forma, há um processo inflamatório reacional intenso ocasionando lesão na parede do vaso, a qual aumenta a permeabilidade dele que resulta em extravasamento de eritrócitos e fluídos 6 . Fundamentado no exposto, alçamos a hipótese de que a LCV do caso pode ser um efeito adverso raro da vacina contra a COVID-19 ao passo que ela pode desencadear a formação de anticorpos, ativação de células B/T autorreativas e a deposição dos imunocomplexos dentro de pequenos vasos 2 .…”

Section: Discussão Do Casounclassified

“…Quanto ao diagnóstico, considera-se a confirmação pelo exame histopatológico, em que se constata a infiltração inflamatória com fragmentação dos núcleos de neutrófilos instalados na parede vascular designada cariorrexe e associado a necrose fibrinóide. O diagnóstico diferencial é amplo em consequência da complexidade e inespecificidade do quadro clínico e, por conseguinte, demanda uma onerosa investigação 6 . Entretanto, inclui púrpura esteróide, púrpura solar, trauma, amiloidose, síndrome de Ehlers-Danlos, as quais consistem em anormalidades não inflamatórias da parede dos vasos; abrange também distúrbios da disfunção plaquetária, defeitos do fator de coagulação e trombocitopenia e lesões à parede do vaso por trombos intravasculares (como coagulação intravascular disseminada).…”

Section: Discussão Do Casounclassified

See 1 more Smart Citation

Vasculite leucocitoclástica após vacina de COVID-19: um relato de caso e revisão da literatura

Herrero,

Pereira,

De Modesti

et al. 2024

CLCS

View full text Add to dashboard Cite

A vasculite leucocitoclástica ou vasculite de hipersensibilidade consiste em um infiltrado inflamatório na parede de capilares, arteríolas e vênulas pós-capilares pela fragmentação de núcleos de neutrófilos. consiste em um delineamento descritivo, de aspecto reflexivo e narrativo, sem grupo controle. Relatamos o caso de uma mulher de 36 anos que desenvolveu vasculite sete dias após receber a primeira dose da vacina Pfizer contra COVID-19. A biópsia de pele revelou presença focal de necrose fibrinóide. Embora a importância dos eventos adversos seja reconhecida, isso não diminui a importância da vacina como medida fundamental e eficaz.

show abstract

Section: Discussão Do Casounclassified

Vasculite leucocitoclástica após vacina de COVID-19: um relato de caso e revisão da literatura

Herrero,

Pereira,

De Modesti

et al. 2024

CLCS

View full text Add to dashboard Cite

show abstract

“…For those infrequent cases of severe forms of CLA, rituximab [44][45][46], infliximab [47], and intravenous immunoglobulin [48] may pose as treatment alternatives. Cyclophosphamide and cyclosporine are usually reserved for refractory, severe, or secondary CLA when other therapies are not available, but with conflicting results [21,[49][50][51]. Figure 2 shows a proposed treatment algorithm for cutaneous leukocytoclastic angiitis.…”

Section: Treatment and Prognosismentioning

confidence: 99%

Localized Forms of Vasculitis

et al. 2021

View full text Add to dashboard Cite

Purpose of Review To provide an updated review on epidemiology, clinical manifestations, diagnostic assessment, treatment, and prognosis of localized vasculitis, following the 2012 Revised International Chapel Hill Consensus Conference Nomenclature on single-organ vasculitis. Recent Findings Localized, single-organ vasculitides encompass a group of rare conditions in which there is no evidence of concomitant systemic vasculitis. Most data on this topic derives from case reports and small case series. Although some aspects of these diseases, such as clinical manifestations and histologic findings, have already been extensively investigated, there is still a lack of robust data concerning the pathogenesis, epidemiology, and treatment. Summary Localized vasculitides may have a wide range of clinical features depending on the organ affected. The inflammatory process may have a multifocal/diffuse or unifocal distribution. Diagnosis is usually based on histopathology findings and exclusion of systemic vasculitis, which may frequently pose a challenge. Further research on treatment is warranted. Keywords Single-organ vasculitis . Cutaneous leukocytoclastic angiitis . Cutaneous arteritis . Isolated aortitis This article is part of the Topical Collection on Vasculitis

show abstract

Ceftriaxone-induced leukocytoclastic vasculitis: a case report and literature review of antibiotic-induced leukocytoclastic vasculitis

et al. 2022

View full text Add to dashboard Cite

Leukocytoclastic vasculitis (hypersensitivity vasculitis) is defined as small blood vessel inflammation with skin or other systemic manifestations due to infections, drugs, or neoplastic disease. This clinical case report highlights an association between ceftriaxone and leukocytoclastic vasculitis in a 49-year-old female patient with a history of penicillin allergy, on mirtazapine for anxiety disorder. Articles concerning antibiotic-induced leukocytoclastic vasculitis are also reviewed. The patient reported a symptom of upper respiratory tract infection and fever 5 days previously for which she received ceftriaxone for 2 days before presenting to the emergency department with a pruritic skin rash in the upper and lower extremities and swollen lips for 1 day. The rash was erythematous, maculopapular, itchy, and non-tender, with no mucus membrane involvement. Laboratory investigations revealed leukocytosis (white blood cells, 22.3 × 109/L) that was mainly eosinophilic (18.4%). The patient was administered prednisolone and antihistamine after stopping ceftriaxone empirically. A skin biopsy confirmed the diagnosis of leukocytoclastic vasculitis. Significant clinical improvement was observed after treatment initiation. Upon follow-up, the skin rash was resolved entirely with no scars; however, there was skin-peeling over the lower extremities. Recognition of antibiotic-induced leukocytoclastic vasculitis is crucial as many classes of antibiotics can contribute to this condition. Continuation of the offending drug may lead to life-threatening complications.

show abstract

Diagnóstico e terapêutica precoce de vasculite leucocitoclástica: relato de caso

Cited by 4 publications

References 21 publications

Vasculite leucocitoclástica após vacina de COVID-19: um relato de caso e revisão da literatura

Vasculite leucocitoclástica após vacina de COVID-19: um relato de caso e revisão da literatura

Localized Forms of Vasculitis

Ceftriaxone-induced leukocytoclastic vasculitis: a case report and literature review of antibiotic-induced leukocytoclastic vasculitis

Contact Info

Product

Resources

About