Drug-induced vasculitis

Abstract

Many therapeutic agents, including recently introduced biologic response modifiers, can induce a variety of vasculitic manifestations ranging from small vessel hypersensitivity vasculitis and leukocytoclastic vasculitis to distinct vasculitic syndromes such as Wegener's granulomatosis, polyarteritis nodosa, and Churg Strauss syndrome. The pathogenic mechanisms remain to be defined and appear to be multifactorial, with cell-mediated and humural immune mechanisms playing important roles. Clinical presentation varies in severity from mild to severe and even fatal illness, can be self-limiting, or follows a more chronic protracted course. There are no significant differences in clinical presentation, serologic abnormalities, and pathologic findings with the idiopathic forms of vasculitis. However, it is extremely important to identify the offending drug because the discontinuation of the drug is often followed by a rapid improvement of the underlying vasculitic disorder.

Cutaneous Vasculitis Update: Small Vessel Neutrophilic Vasculitis Syndromes

“…There are no significant differences in clinical presentation, serologic abnormalities, and pathologic findings compared to idiopathic vasculitides. 71 The interval between the first exposure and appearance of symptoms for drug-induced vasculitis can be extremely variable (ie, hours to years), with the vasculitis commencing after drug dosage increases and after rechallenge. In most instances, withdrawal of the offending agent alone is often sufficient to induce prompt resolution of clinical manifestations.…”

Severe systemic vasculitis in a neonate

“…The severe eosinophilic vasculitis noted in our newborn did not recur after short-term steroid treatment. This fact strongly argues for a vasculitis secondary either to drugs or acute infections [2,6]. Both streptococci and staphylococci, the causative agents of the severe thoracic infection of our patient, have been known or suspected to cause vasculitides.…”

Patología aórtica no urgente: diagnóstico clínico-radiológico de la aortitis

“…Aortitis secundaria a fármacos. La vasculitis inducida por fármacos merece un apartado especial, puesto que muchos agentes terapéuticos (como el propiltiouracilo, la minociclina, los derivados retinoides o los antagonistas del receptor de leucotrienos) 36 han sido implicados en el desarrollo de una enfermedad vascular inflamatoria. Los pacientes acuden con síntomas muy variados, que van desde fiebre de origen desconocido o mialgias, a una vasculitis cutánea aislada o a una afectación generalizada de órganos internos 37 .…”