Leukocytoclastic vasculitis associated with multifocal sensory neuropathy responsive to intravenous immunoglobulins: a case report.

Main Article Content

Elena Cama
Martina Ferranti
Mario Cacciavillani
Franco Schiavon
Mara Felicetti
Chiara Abriani
Mauro Alaibac

Keywords

Leukocytoclastic vasculitis, Sensory neuropathy, Intravenous immunoglobulins

Abstract

Leukocytoclastic vasculitis (LCV) is a common form of small-vessel vasculitis, which commonly presents as palpable purpura or petechiae, caused by deposition of circulating immune complexes on vessels walls that attracts granulocytes which damage the vascular endothelium and leading to erythrocytes extravasation. The skin is the most commonly involved organ, but also renal, gastrointestinal, pulmonary, cardiovascular and neurological systems may be affected. Skin lesions may be the initial signs of systemic vasculitis. Systemic symptoms may be present, such us fever, myalgia, abdominal pain and arthralgia. The presence of neuropathy/mononeuritis multiplex is expression of severe vasculitic involvement.


Herein, we describe the case of a patient with leucocytoclastic vasculitis associated to sensitive neuropathy, responsive to intravenous immunoglobulins (IGIV) therapy, after the failure of classic systemic treatments.

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References

1. Watts RA, Robson J. Introduction, epidemiology and classification of vasculitis. Best Pract Res Clin Rheumatol 2018;32(1):3-20. doi: 10.1016/j.berh.2018.10.003.
2. Koutkia P, Mylonakis E, Rounds S, Erickson A. Leucocytoclastic vasculitis: an update for the clinician. Scand J Rheumatol 2001;30(6):315-22. doi: 10.1080/030097401317148499.
3. Aounallah A, Arouss A, Ghariani N, Saidi W, Sriha B, Denguezli M, et al. Vascularites cutanées leucocytoclasiques: à propos de 85 cas. Pan Afr Med J 2017;26:138. doi:10.11604/pamj.2017.26.138.9721.
4. Elefante E, Bond M, Monti S, Lepri G, Cavallaro E, Felicetti M, et al. One year in review 2018: systemic vasculitis. Clin Exp Rheumatol 2018;36 Suppl 111(2):12-32. PMID: 29799395.
5. Marzano AV, Vezzoli P, Berti E. Skin involvement in cutaneous and systemic vasculitis. Autoimmun Rev 2013;12(4):467-476. doi:10.1016/j.autrev.2012.08.005.
6. Seo JH, Ryan HF, Claussen GC, Thomas TD, Oh SJ. Sensory neuropathy in vasculitis: a clinical, pathologic, and electrophysiologic study. Neurology 2004;63(5):874-878. doi:10.1212/01.wnl.0000137017.45065.3e.
7. Younger DS, Carlson A. Dermatologic Aspects of Systemic Vasculitis. Neurol Clin 2019;37(2):465-473. doi:10.1016/j.ncl.2019.01.017.
8. Sunderkötter C, Bonsmann G, Sindrilaru A, Luger T. Management of leukocytoclastic vasculitis. J Dermatolog Treat. 2005;16(4):193-206. doi:10.1080/09546630500277971
9. Younger DS. Treatment of Vasculitis of the Nervous System. Neurol Clin 2019;37(2):399-423. doi:10.1016/j.ncl.2019.01.014.
10. Eleftheriou D, Brogan PA. Therapeutic advances in the treatment of vasculitis. Pediatr Rheumatol Online J 2016 Apr 26;14(1):26. doi: 10.1186/s12969-016-0082-8.
11. Ballow M. Mechanisms of immune regulation by IVIG. Curr Opin Allergy Clin Immunol 2014; 14(6):509-515. doi: 10.1097/ACI.0000000000000116.
12. Mulhearn B, Bruce IN. Indications for IVIG in rheumatic diseases. Rheumatology (Oxford) 2015;54(3):383-91. doi: 10.1093/rheumatology/keu429.