Presentation
Since vasculitic paraneoplastic syndromes, including CLV, may develop before the clinical presentation of malignant tumors, the present case and others previously reported strongly suggest that in apparently idiopathic CLV, patients should be evaluated [ncbi.nlm.nih.gov]
Entire Body System
- Fever
After anti-tuberculosis treatment, his fever declined and the skin purpura were completely resolved. Although incidence is rare, tuberculosis should be considered as a possible cause of CLV. [ncbi.nlm.nih.gov]
Many patients develop skin lesions, particularly on the legs, accompanied by arthralgia and fever. The disorder is seen in rheumatoid arthritis and other diseases. [medical-dictionary.thefreedictionary.com]
He presented with a palpable purpura on both legs, low-grade fever, cough and expectoration, progressive dyspnea due to a massive left pleural effusion and a symmetric swelling on his ankles and wrists. [link.springer.com]
- Inflammation
Careful examination of ocular inflammation is important in monitoring systemic disease and treatment. [ncbi.nlm.nih.gov]
- Weight Loss
The patient sought emergency treatment presenting with headache, arthralgia, cutaneous rash, and weight loss (4 kg) in the last 20 days. [ncbi.nlm.nih.gov]
General symptoms such as fevers, weight loss and muscle aches may occur. Five to 25% of people with CSVV can have joint, genitourinary or gastrointestinal symptoms. This raises the possibility of internal involvement. [dermcoll.edu.au]
She reported a 6-month history of dry cough, anorexia-cachexia, and 4 kg weight loss. On physical examination, she was seen to be asthenic, with a poor-to-middling general condition, body mass index 17.42, blood pressure 139/93, temperature 36.7 °C. [archbronconeumol.org]
Patients can present to the family physician with nonspecific signs or symptoms (e.g., fever, rash, myalgia, arthralgia, malaise, weight loss) or to the emergency department with life-threatening features (e.g., massive hemoptysis, renal failure). [aafp.org]
- Malaise
Over the past 3 to 4 weeks, he has had malaise, nonproductive cough, and a decline in mental status but no fever, headache, nausea, light-headedness, hemoptysis, or melena. [consultant360.com]
There may also be fever, generalized discomfort (malaise), muscle or joint pain. Causes The exact cause of cutaneous necrotizing vasculitis is unknown. [rarediseases.org]
He also complained of low-grade fever, malaise and arthralgias involving the back and knees since one month. Examination revealed edema of both feet and pallor. [ijdvl.com]
These forms present as a viral infection, with polyarthralgias, fever, malaise, fatigue and possible neurological manifestations. [clinicaldermatology.eu]
- Pathologist
"Dermatopathology for the surgical pathologist: a pattern-based approach to the diagnosis of inflammatory skin disorders (part II).". Adv Anat Pathol 15 (6): 350-69. doi : 10.1097/PAP.0b013e31818b1ac6. [librepathology.org]
The diagnosis by the pathologist was probable panniculitis which ‘could be the surface of erythema nodosum. It was discovered that the patient’s cholesterol level was greater than 900 and he was started on statin therapy. [ispub.com]
Gastrointestinal
- Abdominal Pain
Abdominal pain occurred in 42 per cent of the male patients while none of the female patients had this symptom. Arthralgia occurred in 20 per cent of the patients. [ncbi.nlm.nih.gov]
Commonest symptom was abdominal pain (27.55%), followed by arthralgia (25.51%) and pruritus (24.49%). Majority of cases had unknown etiology (69.07%). Those with documented etiology included infection (25.51%) and drugs (5.10%). [nepjol.info]
Signs of systemic involvement include fever, muscle aches, joint pain, blood in the urine or stool, abdominal pain, vomiting, cough, numbness, and weakness. [aocd.org]
The signs of systemic involvement include fever, myalgia (pain in the muscles), arthralgia (pain in the joints) hematuria (blood in the urine), melena (blood in the stools), abdominal pain, weakness, and numbness. [news-medical.net]
For example, a patient with purpura, nephritis, and abdominal pain caused by Henoch–Schönlein purpura usually has a good prognosis. .. [nejm.org]
- Nausea
The most common adverse events associated with the quinolone class involve the gastrointestinal tract (nausea and diarrhea) and central nervous system (CNS) (headache and dizziness). [scienceopen.com]
A 34-year-old Hispanic man with a history of alcoholic cirrhosis and type 2 diabetes mellitus presented with 2 weeks of diarrhea, nausea, vomiting, abdominal pain, rash, and syncope. [amjmed.org]
Over the past 3 to 4 weeks, he has had malaise, nonproductive cough, and a decline in mental status but no fever, headache, nausea, light-headedness, hemoptysis, or melena. [consultant360.com]
[…] myxoma【歯原性粘液腫】 *myxomatosis【粘液腫症】 *myxorrhea【粘液漏】 *myxosarcoma【粘液肉腫】 (N) *naevus fuscocaerules ophthalmomaxillaris【眼上顎褐青色母斑】[L] *nail ringworm【爪白癬】(tinea unguium[L]) *nanocephaly【小頭症】 *nasal obstruction【鼻閉塞】 *nasal polyp【鼻ポリープ∥鼻茸】 *nasopharyngitis【鼻咽頭炎】 *nausea [medo.jp]
Cardiovascular
- Vascular Disease
CLV causative factors or associated diseases are usually drugs, infection, or collagen vascular disease, but rarely malignancies. In such cases, these are more often malignant hematologic diseases than solid neoplasms. [ncbi.nlm.nih.gov]
some viral infections, collagen vascular disease, PLEVA and erythema multiforme Fibrin thrombi: present in segmented, hyalinizing vasculitis Infarct of skin: associated with malignant atrophic papulosis (Dego's disease); intimal proliferation of deep-seated [pathologyoutlines.com]
- Tachycardia
【頻脈】 ⇒supraventricular tachycardia【上室性頻脈】 *tachylalia【速語症】 *tachyphagia【速食症】 *tachyphrasia【速語症】 *tachypnea【頻呼吸∥多呼吸】 *Takayasu arteritis【高安動脈炎】 *Takayasu disease【脈なし病】(pulseless disease) *talcosis【滑石沈着(症)】 *talipes【彎足∥彎曲足】 *talipes calcaneovalgus【外反踵足】 [medo.jp]
Musculoskeletal
- Arthritis
The disorder is seen in rheumatoid arthritis and other diseases. [medical-dictionary.thefreedictionary.com]
In adults, arthritis and kidney disease occur more frequently. [8] HSP in adults, especially older men, may be associated with malignancy. [9] For additional information on HSP, see Henoch-Schönlein purpura. [emedicine.medscape.com]
Long-term evaluation of intermittent levamisole treatment in rheumatoid arthritis Veys, E M; Mielants, H. In: International Meeting on Future Trends in Inflammation (3d : 1977 : London). [ncbi.nlm.nih.gov]
Other: Connective tissue disease, e.g. mixed connective tissue disease, SLE, rheumatoid arthritis. Cryoglobulinemia - may be due to multiple myeloma, hepatitis C ; have intravascular thrombi. Paraneoplastic. Drugs. [librepathology.org]
Unique syndrome of cutaneous angiitis and arthritis associated with myeloproliferative disorders. Am J Med 1986;80:1027-30. 4. McLean DI. Cutaneous paraneoplastic syndromes. Arch Dermatol 1986;122:765-7. [ PUBMED ] 5. [cancerjournal.net]
- Arthralgia
The patient sought emergency treatment presenting with headache, arthralgia, cutaneous rash, and weight loss (4 kg) in the last 20 days. [ncbi.nlm.nih.gov]
Many patients develop skin lesions, particularly on the legs, accompanied by arthralgia and fever. The disorder is seen in rheumatoid arthritis and other diseases. [medical-dictionary.thefreedictionary.com]
Commonest symptom was abdominal pain (27.55%), followed by arthralgia (25.51%) and pruritus (24.49%). Majority of cases had unknown etiology (69.07%). Those with documented etiology included infection (25.51%) and drugs (5.10%). [nepjol.info]
Cryoglobulins, arthralgia and normal temperature are risk factors for chronic cutaneous disease [ 18 ]. [patient.info]
- Myalgia
Here, we report a 49-year-old male patient that presented with fever, myalgia, and multiple palpable purpura on both of his legs. The biopsy from the purpura yielded a histologic diagnosis of leukocytoclastic vasculitis. [ncbi.nlm.nih.gov]
The signs of systemic involvement include fever, myalgia (pain in the muscles), arthralgia (pain in the joints) hematuria (blood in the urine), melena (blood in the stools), abdominal pain, weakness, and numbness. [news-medical.net]
Patients can present to the family physician with nonspecific signs or symptoms (e.g., fever, rash, myalgia, arthralgia, malaise, weight loss) or to the emergency department with life-threatening features (e.g., massive hemoptysis, renal failure). [aafp.org]
Arthralgia or myalgia. Look at past medical history, including possible intravenous drug use, hepatitis, transfusion and travel. [patient.info]
Besides this classical form, there is also a cutaneous polyarteritis nodosa that presents with systemic symptoms as well, including low-grade fever, myalgia, arthralgia and peripheral neuropathy, but especially with very painful erythematous nodules in [clinicaldermatology.eu]
Skin
- Purpura
The absence of IgA ACAs in Henoch-Schönlein purpura argues against their being an epiphenomenon in vasculitis. [ncbi.nlm.nih.gov]
Reyes Memorial Medical Center Keywords: Leukocytoclastic vasculitis, Palpable purpura, Henoch-Schönlein purpura, Hypersensitivity vasculitis Abstract Introduction: Leukocytoclastic vasculitis (LCV) is the commonest vasculitis of skin affecting small vessels [nepjol.info]
[…] of red cells; may be limited to the skin or involve other tissues as in Henoch-Schönlein purpura. [medical-dictionary.thefreedictionary.com]
- Palpable Purpura
Reyes Memorial Medical Center Keywords: Leukocytoclastic vasculitis, Palpable purpura, Henoch-Schönlein purpura, Hypersensitivity vasculitis Abstract Introduction: Leukocytoclastic vasculitis (LCV) is the commonest vasculitis of skin affecting small vessels [nepjol.info]
[…] leu·ko·cy·to·clas·tic vas·cu·li·tis cutaneous acute vasculitis characterized clinically by palpable purpura, especially of the legs, and histologically by exudation of the neutrophils and sometimes fibrin around dermal venules, with nuclear dust and extravasation [medical-dictionary.thefreedictionary.com]
Leukocytoclastic vasculitis (LCV), a disease characterized by inflammation of the small vessels, presents with palpable purpura, especially in the lower extremities. [ncbi.nlm.nih.gov]
- Ulcer
Despite high-dose prednisone therapy, the pathergy test remained markedly positive; however, no new skin ulcerations appeared. [ncbi.nlm.nih.gov]
الصفحة 55 - Stimulation of repair in chronic, nonhealing, cutaneous ulcers using platelet-derived wound healing formula. Surg Gynecol Obstet 1990;170:56-60. [books.google.com]
In August 2010, he resumed poor eating habits once again with recurrence of a rash, nodules, and ulcers after 2 months. [ispub.com]
Ulcerated lesions, particularly those on the lower limbs, may be slow to heal. Cutaneous LCV may be chiefly an aesthetic concern. The purpuric lesions are rarely painful unless they become ulcerated. [rheumatologyadvisor.com]
- Urticaria
Since serologic testing has become available there have been several reports of cutaneous findings in association with hepatitis C virus infection, including vasculitis, cryoglobulinemia, urticaria, and lichen planus. [ncbi.nlm.nih.gov]
Leukocytoclastic vasculitis: characteristic skin lesions allergic vasculitis A form of nonthrombocytopenic purpura due to a hypersensitivity vasculitis associated with urticaria, erythema, arthritis, gastrointestinal symptoms and renal involvement. leukocytoclastic [medical-dictionary.thefreedictionary.com]
Sometimes there is urticaria: This is different from the usual pattern of urticaria in that it tends to last for more than 24 hours and may leave ecchymoses or pigmentation. The sensation is burning rather than itching. [patient.info]
[…] also: Cutaneous conditions, Category:Cutaneous conditions, and ICD 10… … Wikipedia Systemic vasculitis — Classification and external resources ICD 10 M30 M31 ICD 9 … Wikipedia urticarial vasculitis — a group of cutaneous vasculitides characterized by urticaria [medicine.academic.ru]
Patients may present with skin symptoms such as lesions, including palpable purpura, petechiae, urticaria, ulcers, livedo reticularis, and nodules. [msdmanuals.com]
- Pruritus
It is sometimes associated with skin pruritus or tenderness. Clinically, LCV presents with an eruption of palpable monomorphous purpuric papules, which may have central vesicles or pustules and may coalesce into larger plaques. [derm101.com]
Genetic basis of cutaneous diseases Arne Kanig and Rudolf Happle Ichthyoses erythrokeratodermas and related disorders Keratodermas Kro Dariers disease and HaileyHailey disease Daniel Hohl Theodora Mauro and leanPhilippe Gorog Mosaicism and linear lesions Pruritus [books.google.com]
Commonest symptom was abdominal pain (27.55%), followed by arthralgia (25.51%) and pruritus (24.49%). Majority of cases had unknown etiology (69.07%). Those with documented etiology included infection (25.51%) and drugs (5.10%). [nepjol.info]
Three weeks after the initiation of sirolimus, the patient reported red, painful papules on her calves without signs of fever, pruritus, joint pain, stiffness, melena, or hematuria. [journals.lww.com]
Antihistamines may help pruritus. Sometimes the older, sedating ones are better. NSAIDs are sometimes beneficial. The first-choice agents for mild recurrent disease are colchicine, dapsone and prednisolone [ 3 ]. [patient.info]
Face, Head & Neck
- Facial Pain
melena, peripheral neuritis, renal ischemia Large vessel Giant cell arteritis Extracranial branches of carotid artery, often involves temporal artery 50 to 60 Fever, visual disturbances, facial pain and headache (often along the course of superficial [aafp.org]
Neurologic
- Stroke
Vasculitis in the brain may cause a stroke, or in the heart, may result in a heart attack. Inflammation in the kidney could result in abnormalities noted on urine tests and can lead to progressive kidney failure. [webmd.com]
(≥ 10 red blood cells per high-power field) □ Hypertension □ Proteinuria > 1+ □ Nervous system □ Cord lesion □ Cranial nerve palsy □ Headache □ Meningitis □ Motor mononeuritis multiplex □ Seizures (not hypertensive) □ Sensory peripheral neuropathy □ Stroke [aafp.org]
- Hyperactivity
水頭症】 ⇒normal pressure hydrocephalus【正常圧水頭症】[略 NPH] *hydromyoma【水筋腫】 *hydrophobia【狂水病】 *hydronephrosis【水腎症】 *hydropelvis【水腎盂症】 *hydrosalpinx【卵管水腫∥卵管留水症】 *hygroma【滑液嚢水腫∥ヒグローマ】 *hygroma axillare【腋窩ヒグローマ】[L] *hymenitis【処女膜炎】 *hypacusis【聴力低下】(hypoacusis) *hyperactivity [medo.jp]
Workup
IgA vasculitis is more likely to present with abdominal pain, bloody urine, and joint pain. [11] In the case that the cause is not obvious, a reasonable initial workup would include a complete blood count, urinalysis, basic metabolic panel, fecal occult [en.wikipedia.org]
A serological workup revealed a negative ANA, ANCA, Rheumatoid factor, Anti-cardiolipin antibodies, lupus anticoagulant, beta 2 glycoprotein, and Hepatitis C antibodies. Cryoglobulins and cold agglutinins were negative on two separate occasions. [ispub.com]
A thorough workup is needed to diagnose the underlying condition. We report two patients presenting with LCV who were found to have multiple myeloma on investigation. [ijdvl.com]
Serum
- Neutrophilia
In this case, essential thrombocytosis is the most likely diagnosis because thrombocytosis but not neutrophilia persisted during immunosuppressive therapy. [care.diabetesjournals.org]
All were normal except for a slight leukocytosis with neutrophilia and positive ASO titer, suggestive of streptococcal wound infection. [derm101.com]
Neutrophilic dermatosis, which is also a reactive hypersensitivity process that occurs in response to systemic factors such as infection, inflammation, hematologic abnormalities, vaccination or drug exposure is primarily neutrophil mediated, associated with neutrophilia [jmedicalcasereports.biomedcentral.com]
Treatment
Response to treatment was judged according to the reduction in the number of lesions. [ncbi.nlm.nih.gov]
Prognosis
When IgG or IgM immune complexes are involved, the prognosis is better, since there is a less likelihood of systemic pathologies. Management and Prognostic Factors In general, individuals with hypersensitivity vasculitis have a very good prognosis. [news-medical.net]
We suggest that absence of autoimmune phenomena and immune-complex in the skin lesions of CLV may be a hallmark of good prognosis. [ncbi.nlm.nih.gov]
Etiology
Majority of cases had unknown etiology (69.07%). Those with documented etiology included infection (25.51%) and drugs (5.10%). Leukocytosis was commonest laboratory abnormality. [nepjol.info]
Abstract Forty-five patients with histologically proved cutaneous leukocytoclastic vasculitis were studied with regard to the clinical features, laboratory findings and etiology. [ncbi.nlm.nih.gov]
Epidemiology
Objectives: To study epidemiology, etiology, clinical and laboratory features and treatment outcomes in LCV patients. [nepjol.info]
Epidemiology Frequency United States The incidence of leukocytoclastic vasculitis is unknown, but the disorder is presumed to be uncommon. [emedicine.medscape.com]
[…] how these impact on activity and toxicity; (2) resistance mechanisms (mutations in target genes, efflux pumps); (3) their pharmacodynamic properties (AUC/MIC and Cmax/MIC ratios; mutant prevention concentration and mutant selection window); and (4) epidemiological [scienceopen.com]
Epidemiology The disease is in many ways similar to Henoch-Schönlein purpura. [patient.info]
Glucocorticoids Although cutaneous small-vessel vasculitis is not rare, few epidemiological studies and no large controlled therapeutic trials have been conducted. [rheumatologyadvisor.com]
Pathophysiology
The exact pathophysiological mechanisms of ANCA and adhesion molecules are unclear. If IgA immune complexes are the dominant immunoglobulins involved, there is a greater chance of systemic involvement in both children and adults. [news-medical.net]
Pharmacotherapy: a pathophysiological approach, 4th ed. Norwalk, Appleton & Lange 1999: 1510. © 2002 Lippincott Williams & Wilkins, Inc. [journals.lww.com]
Pathophysiology Immune complex deposition, with resultant neutrophil chemotaxis and release of proteolytic enzymes and free oxygen radicals, is a key component in the pathophysiology of LCV. [10, 11] In addition, other autoantibodies, such as antineutrophil [emedicine.medscape.com]
This finding on histological examination is termed “leukocytoclastic vasculitis”. [5] Considering the wide range of potential causes leading to cutaneous small vessel vasculitis, there are subtle variations in the underlying pathophysiology for each cause [en.wikipedia.org]
Although a precise pathophysiologic mechanism has not yet been identified for the development of LCV, several theories have been proposed. [springerplus.springeropen.com]
Prevention
Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.com]
How can cutaneous small vessel vasculitis be prevented? Flares of cutaneous small vessel vasculitis can be minimised by rest, compression and elevation of lower legs. [dermnetnz.org]
[…] based on an understanding of: (1) their chemical structures and how these impact on activity and toxicity; (2) resistance mechanisms (mutations in target genes, efflux pumps); (3) their pharmacodynamic properties (AUC/MIC and Cmax/MIC ratios; mutant prevention [scienceopen.com]
A worldwide, phase III, randomized, controlled, safety and efficacy study of a sirolimus/cyclosporine regimen for prevention of acute rejection in recipients of primary mismatched renal allografts. Transplantation 2001; 71: 271. 3. [journals.lww.com]
Early treatment with azathioprine plus steroids prevented progression of chronic kidney disease [ 52 ]. [intechopen.com]