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
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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]
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]
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]
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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]
The clinician should ask about the duration, onset, and presence any associated symptoms such as weight loss or fatigue (that would indicate a systemic cause). [10] It is important to distinguish between IgA and non-IgA vasculitis. [en.wikipedia.org]
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]
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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]
These forms present as a viral infection, with polyarthralgias, fever, malaise, fatigue and possible neurological manifestations. [clinicaldermatology.eu]
fever, rash, myalgia, arthralgia, malaise, weight loss) or to the emergency department with life-threatening features (e.g., massive hemoptysis, renal failure). Manifestations vary, depending on the size, site, and extent of vessels involved. [aafp.org]
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Chills
English Allergic skin reactions (including rash), itching, hot flushes, fever, chills. [mymemory.translated.net]
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Hypoxemia
【低体温】 *hypothymia【気分沈滞】 *hypothyroidism【甲状腺機能低下(症)】 *hypotonia【低圧】 *hypotrichosis【先天性貧毛(症)】 hypotrichosis congenita【先天性貧毛(症)】[L] *hypoventilation【低換気 呼吸低下】(underventilation) *hypovitaminosis【ビタミン不足(症)】 *hypovolemia【低血液量[症] 血液量減少(症)】 *hypovolia【減量症】 *hypoxemia [medo.jp]
Gastrointestinal
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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]
For example, if the vasculitis is a manifestation of Henoch-Schönlein purpura, individuals may also experience abdominal pain or blood in the urine. [5] Cause [ edit ] Cutaneous vasculitis can have various causes including but not limited to medications [en.wikipedia.org]
The patient denied having a fever, abdominal pain, or arthralgia. Laboratory studies revealed normal platelet counts and coagulability. Renal function was unimpaired, and the results of urinalysis were insignificant. [e-ijd.org]
He had not hematuria neither abdominal pain. He had a history of a penicillin allergy. Medications included Metformin (1700 mg daily) and Glimepiride (4mg daily) for four years. The patient was febrile. [pubs.sciepub.com]
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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]
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Abdominal Cramps
Side effects were uncommon but, when they occurred, consisted mainly of abdominal cramping and/or diarrhea. [ncbi.nlm.nih.gov]
Cardiovascular
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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
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Arthritis
Autoimmune disorders such as systemic lupus erythematosus (SLE), dermatomyositis, and rheumatoid arthritis are characterised by circulating antibodies that target the individual's tissues. [dermnetnz.org]
Arthritis & Rheumatism. 65 (1): 1–11. doi : 10.1002/art.37715. PMID 23045170. 1950-, James, William D. (William Daniel) (2015-04-20). Andrews' diseases of the skin : clinical dermatology. [en.wikipedia.org]
The disorder is seen in rheumatoid arthritis and other diseases. [medical-dictionary.thefreedictionary.com]
Semin Arthritis Rheum 1998;27:319–324. Sigurgeirsson B, Lindelof B, Edhag O, Allander E: Risk of cancer in patients with dermatomyositis or polymyositis: A population-based study. N Engl J Med 1992;326:363–367. [karger.com]
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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]
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]
In all cases, systemic complications, such as renal failure, abdominal discomfort, and arthralgia, were not mentioned. [e-ijd.org]
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]
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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]
fever, rash, myalgia, arthralgia, malaise, weight loss) or to the emergency department with life-threatening features (e.g., massive hemoptysis, renal failure). Manifestations vary, depending on the size, site, and extent of vessels involved. [aafp.org]
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]
Arthralgia or myalgia. Look at past medical history, including possible intravenous drug use, hepatitis, transfusion and travel. [patient.info]
Skin
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Purpura
The absence of IgA ACAs in Henoch-Schönlein purpura argues against their being an epiphenomenon in vasculitis. [ncbi.nlm.nih.gov]
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Palpable Purpura
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]
Palpable purpura in lower limb was commonest presentation. Majority were idiopathic LCV. Amoxicillin and UTI were commonest among causes of drugs and infection, respectively. Commonest abnormality was leukocytosis. [nepjol.info]
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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]
The skin lesions spread progressively over the entire body, and several lesions coalesced, resulting in blisters and ulcers ( Fig. 1 ). The patient had no history of atopy or drug allergy. [synapse.koreamed.org]
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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]
[…] 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]
Cutaneous adverse reactions to anti-tuberculosis drugs have been reported in up to 5% of treated patients. 8 Common cutaneous reactions include pruritus, skin eruptions, maculopapular exanthems, urticaria, pustules, fixed reactions, and erythema nodosum [synapse.koreamed.org]
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]
[…] features of hypersensitivity vasculitis include: Prominent involvement of lower legs with fewer lesions on proximal sites Palpable purpura (purple, non- blanching papules and plaques ) Sometimes, petechiae and ecchymoses Non-purpuric erythematous or urticaria-like [dermnetnz.org]
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Petechiae
A 71-year-old man presented with a high fever, polyarthralgia, petechiae and palpable purpura accompanied by livedoid change on his legs and feet. [ncbi.nlm.nih.gov]
The most common presentation of CSVV is raised red-purple spots (purpura, 0.3 to 1 cm in diameter) and/or petechiae (purpuric lesions less than 3 mm in diameter) which do not disappear with pressure (i.e. non-blanching). [dermcoll.edu.au]
Patients may present with skin symptoms such as lesions, including palpable purpura, petechiae, urticaria, ulcers, livedo reticularis, and nodules. [msdmanuals.com]
Common Features Petechiae : Petechiae are nonblanchable, pinpoint macules (less than a few millimeters in diameter) that result from capillary inflammation and red blood cell extravasation Shaimaa Elkoly, M.D. Cairo University 14. [slideshare.net]
The clinical features of hypersensitivity vasculitis include: Prominent involvement of lower legs with fewer lesions on proximal sites Palpable purpura (purple, non- blanching papules and plaques ) Sometimes, petechiae and ecchymoses Non-purpuric erythematous [dermnetnz.org]
Neurologic
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Generalized Seizure
seizure【全身性発作】 *geographic choroidopathy【地図状脈絡膜症】 *geographic keratitis【地図状角膜炎】 *geographic stippling of nails【爪甲地図状斑点】 *geographic tongue【地図状舌】 *germinoma【胚細胞腫】 *giant cell【巨細胞】 central giant cell granuloma【中心性巨細胞肉芽腫】 *giant cell fibroma【巨細胞性線維腫】 *giant [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]
Serum
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Hypocapnia
*hypervascularity【血管分布過多】 *hyperventilation【過換気】 *hypesthesia【感覚減退 感覚鈍麻】(hypoesthesia) olfactory hypesthesia【嗅覚鈍麻】 *hypoacusis【聴力低下】(hypacusis) *hypoalphalipoproteinemia【低α蛋白血(症)】 *hypoalimentation【低栄養】 *hypobarism【低圧(症)】 *hypocalcemia【低カルシウム血(症)】 *hypocapnia [medo.jp]
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Immunoglobulin G Decreased
Serum concentrations of immunoglobulin G decreased and plasma cells in bone marrow decreased. [ncbi.nlm.nih.gov]
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Immunoglobulin A Decreased
Serum concentrations of immunoglobulin G decreased and plasma cells in bone marrow decreased. [ncbi.nlm.nih.gov]
Biopsy
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Hepatocellular Carcinoma
There are no other reports about erlotinib-induced leukocytoclastic vasculitis (LV) in the erlotinib-bevacizumab regimen for bone metastasis, from a relapsed hepatocellular carcinoma (HCC) in liver-transplanted patients. [ncbi.nlm.nih.gov]
carcinoma) *hepatocellular carcinoma【肝細胞癌】(hepatocarcinoma) *hepatocellular jaundice【肝細胞性黄疸】 *hepatocholangiocarcinoma【胆管肝癌】 *hepatocholangitis【肝胆管炎】 *hepatocirrhosis【肝硬変症】 *hepatodynia【肝臓痛】(hepatalgia) *hepatojugular reflux【肝頚静脈逆流】 *hepatolithiasis【 [medo.jp]
Treatment
Response to treatment was judged according to the reduction in the number of lesions. [ncbi.nlm.nih.gov]
Prognosis
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]
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]
Etiology
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]
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]
Epidemiology
Objectives: To study epidemiology, etiology, clinical and laboratory features and treatment outcomes in LCV patients. [nepjol.info]
[…] 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 Frequency United States The incidence of leukocytoclastic vasculitis is unknown, but the disorder is presumed to be uncommon. [emedicine.medscape.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]
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]
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]
Additional treatments From a pathophysiological point of view, the removal of any source of chronic bacterial challenge, which may trigger HSP episodes, should theoretically be beneficial [ 70 ]. [intechopen.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]
Early treatment with azathioprine plus steroids prevented progression of chronic kidney disease [ 52 ]. [intechopen.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]