Gastroenterology Cases of Cutaneous Leukocytoclastic Vasculitis

Karatoprak, Cumali; Arabaci, Elif; Yıldız, Kemalettin; Çakırca, Mustafa; Çıkrıkçıoğlu, Mehmet Ali; Ergun, Fatih; Danalıoğlu, Ahmet; Kocaman, Orhan; Şentürk, Hakan

doi:10.1155/2013/264189

Cited by 5 publications

(9 citation statements)

References 10 publications

(10 reference statements)

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“…LV is a pathological condition initially defined as a vasculitis of small vessels after drug intake 1. Subsequently, it has been associated with infections such as hepatitis C, connective tissue diseases (rheumatoid arthritis) and malignancies (lymphoproliferative disorders).…”

Section: Discussionmentioning

confidence: 99%

“…Approximately half of the cases are idiopathic 2. Rarely, LV may be associated with IBD or other gastrointestinal conditions, and bowel bypass syndrome and ischaemic colitis 1 3. It usually results from deposition of immune complexes at the vessel wall 4.…”

Section: Discussionmentioning

confidence: 99%

“…Our patient had reported intermittent episodes of diarrhoea and generalised joint pain over the 2-year period, in addition to the acute episode at presentation. Management of LV is based on the degree of systemic involvement and is usually aimed at treating the underlying cause 1 6. A multidisciplinary approach involving different specialty disciplines may be indicated, depending on the presentation 1.…”

Section: Discussionmentioning

confidence: 99%

“…Management of LV is based on the degree of systemic involvement and is usually aimed at treating the underlying cause 1 6. A multidisciplinary approach involving different specialty disciplines may be indicated, depending on the presentation 1. In this case, the rheumatologist, dermatologist, gastroenterologist and a colorectal surgeon were all involved, as the patient needed a combined medical/surgical approach to management.…”

Section: Discussionmentioning

confidence: 99%

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Leukocytoclastic vasculitis associated with perforated diverticular disease

2016

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Leukocytoclastic vasculitis (LV) is a small vessel vasculitis associated with infections, connective tissue disease, malignancies and, rarely, gastrointestinal conditions. An association between LV and acute diverticulitis has not previously been reported. LV may be localised to the skin as a purpuric rash or might manifest with systemic involvement, such as of the joints, gastrointestinal tract or kidneys. Management of LV can be medical or surgical, based on the degree of systemic involvement. We present the case of a 56-year-old man with a 2-year history of a purpuric rash associated with diarrhoea, who presented acutely with abdominal pain. Imaging studies revealed sigmoid diverticulitis with a pericolic collection. Operative findings were purulent peritonitis secondary to perforated diverticular abscess, which was treated with a Hartmann's procedure. Postoperatively, the purpuric rash resolved rapidly on treatment with antibiotics and steroids. Histopathology of the resected bowel and skin punch biopsy confirmed sigmoid diverticulitis and LV, respectively.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Leukocytoclastic vasculitis associated with perforated diverticular disease

2016

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“…heparin needs to be started immediately, later usually replaced by the long-term (mostly life-long) application of coumarin or warfarin. Leukocytoclastic vasculitis, which is even a challenge in diagnosis and treatment if only presenting as cutaneous lesions, frequently requires a full internal medicine department to elucidate the underlying (GI) disease [41]. …”

Section: Treatment and Preventionmentioning

confidence: 99%

Gut and Liver in Vasculitic Disorders

Müller‐Ladner

2016

Dig Dis

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Background: Although the gastrointestinal (GI) tract including its related organs is not generally regarded as one of the primary organ systems of primary and secondary vasculitic disorders, there are numerous mechanisms of these diseases operative in or around the different structures and compartments of the GI tract. Key Messages: A majority of the respective clinical symptoms and problems are linked to an alteration of (peri)vascular homeostasis. Alteration of perivascular matrix metabolism can also affect the functional integrity and motility of the GI tract. Apart from the specific GI phenomena of the individual diseases as outlined in detail in this review, the epidemiology of GI involvement follows in general the characteristics of the respective underlying systemic disease. In addition, gender and age do neither influence the occurrence nor the severity of the GI manifestations significantly. With respect to clinical symptoms, vasculitides may result in abdominal pain, bleeding, ileus, intestinal necrosis and hematochezia because of reduced blood flow and hyper-acute occlusion in the antiphospholipid syndrome. Small-bowel involvement in vasculitic entities can cause pseudoobstruction, obstruction, malabsorption and bacterial overgrowth. Laboratory parameters can point to specific diseases but are frequently nonspecific. Thus, if biopsy fails or in unclear endoscopic situations, a variety of imaging techniques including Doppler ultrasound, abdominal CT, MRI and angiography are used and required for identification and localization of the underlying disease. Therapeutic strategies in vasculitides usually include corticosteroids and immunosuppressants, for example, cyclophosphamide in granulomatosis with polyangiitis and in panarteriitis nodosa but also biologics such as rituximab in ANCA-associated vasculitides. Virostatic drugs including interferon-α and ribavirin can be used in hepatitis B- and C-triggered vasculitides such as panarteriitis nodosa and hepatitis C-associated cryoglobulinemia. Conclusions: Immediate diagnostic and therapeutic steps of action need to be performed if vasculitis of the GI tract is suspected in order to avoid irreversible damage to organs and to improve the well-being and life of the affected patient.

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Vascularites cutanées leucocytoclasiques: à propos de 85 cas

Aounallah¹,

Arouss²,

Ghariani³

et al. 2017

Pan Afr Med J

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La présentation clinique, les étiologies et l'évolution des Vascularites leucocytoclasiques sont peu étudiées. L'objectif de notre travail est d'étudier les particularités épidémiologiques, cliniques, étiologiques et évolutives de cette entité. Nous avons mené une étude transversale portant sur 85 patients ayant une vascularite leucocytoclasique colligés dans le service de dermatologie de l'hôpital Farhat Hached de Sousse entre Janvier 2000 et Décembre 2013. Pour chaque patient, une fiche des données épidémiologiques, cliniques, paracliniques et étiologiques a été remplie. L'âge moyen de nos patients était de 47,65 ans avec des extrêmes allant de 10 à 78 ans. Cinquante trois femmes et 32 hommes étaient recensés (sexe ratio = 0,6). Les manifestations cutanées étaient dominées par le purpura vasculaire (88,2%). Les étiologies les plus fréquentes étaient les maladies systémiques (51%), les infections (20%) et les dermatoses neutrophiliques (14,5%). Les autres étiologies retrouvées étaient : les causes médicamenteuses (9,1%) et les hémopathies malignes (5,4%). Chez 30 patients (35,3%), l'étiologie n'a pas été retrouvée. Deux facteurs prédictifs à l'évolution aigue étaient retenus : la présence d'une infection récente (p= 0,014) et d'une prise médicamenteuse précédant l'éruption cutanée (p= 0,013). L'évolution chronique était corrélée positivement aux anticorps antinucléaires (p= 0,009), et à la cryoglobulinémie (p=0,025). Notre étude illustre la multitude des étiologies de vascularites leucocytoclasiques. La recherche d'une maladie sous-jacente est impérative afin de garantir une meilleure prise en charge thérapeutique.

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Gastroenterology Cases of Cutaneous Leukocytoclastic Vasculitis

Cited by 5 publications

References 10 publications

Leukocytoclastic vasculitis associated with perforated diverticular disease

Leukocytoclastic vasculitis associated with perforated diverticular disease

Gut and Liver in Vasculitic Disorders

Vascularites cutanées leucocytoclasiques: à propos de 85 cas

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