Diagnóstico e terapêutica precoce de vasculite leucocitoclástica: relato de caso
Early diagnosis and treatment of Leukocytoclastic Vasculitis: case report
Alexandre Sacchetti Bezerra; Afonso César Polimanti; Rafael Andretti de Oliveira; Rafael Vilhena de Carvalho Fürst; Paulo Ricardo Criado; João Antônio Corrêa
Resumo
Palavras-chave
Abstract
A 46-year-old female patient presented at the emergency department of a Municipal University Hospital with necrotic lesions in lower limbs associated with wasting syndrome. She was diagnosed with leukocytoclastic vasculitis after physical examination and history-taking in a fast and cost-effective manner, using an algorithm specifically for primary vasculitis, enabling early and appropriate treatment. The good clinical outcome demonstrates the need to quickly make a definitive diagnosis and start treatment.
Keywords
References
1 Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. 2013;65(1):1-11.
2 Brasileiro J, Mendes A, Chen J, Costa I, Ayres L, Santos M. Vasculite leucocitoclástica crônica: relato de um caso e revisão bibliográfica. J Vasc Bras. 2004;3(4):392-6.
3 Alberti-Violetti S, Berti E, Marzano AV. Cutaneous and systemic vasculitides in dermatology: a histological perspective. G Ital Dermatol Venereol. 2018;153(2):185-93. PMid:29368866.
4 Hautmann G, Campanile G, Lotti TM. The many faces of cutaneous vasculitis. Clin Dermatol. 1999;17(5):515-31.
5 Arvan ME, Brodell RT. A palpable clue to vasculitis. Postgrad Med. 1999;105(3):229-32.
6 Rodrigues R, Jorge PT. Vasculite leucocitoclástica: uma rara manifestação associada ao metimazol. Arq Bras Endocrinol Metabol. 2002;46(6):716-9.
7 Bezerra AS, Polimanti AC, Fürst RVC, Corrêa JA. Algorithm for diagnosis of primary vasculitides. J Vasc Bras. 2019;18:e20180092.
8 Yamamoto T, Kaburagi Y, Izaki S, Tanaka T, Kitamura K. Leukocytoclasis: ultrastructural in situ nick end labeling study in anaphylactoid purpura. J Dermatol Sci. 2000;24(3):158-65.
9 Carlson JA. The histological assessment of cutaneous vasculitis. Histopathology. 2010;56(1):3-23.
10 Arora A, Wetter DA, Gonzalez-Santiago TM, Davis MD, Lohse CM. Incidence of leukocytoclastic vasculitis, 1996 to 2010: a population-based study in Olmsted County, Minnesota. Mayo Clin Proc. 2014;89(11):1515-24.
11 Tai YJ, Chong AH, Williams RA, Cumming S, Kelly RI. Retrospective analysis of adult patients with cutaneous leukocytoclastic vasculitis. Australas J Dermatol. 2006;47(2):92-6.
12 Blanco R, Martinez-Taboada VM, Rodriguez-Valverde V, Garcia-Fuentes M. Cutaneous vasculitis in children and adults. Associated diseases and etiologic factors in 303 patients. Medicine (Baltimore). 1998;77(6):403-18.
13 Jokar M, Mirfeizi Z. Epidemiology of Vasculitides in Khorasan Province, Iran. Iran J Med Sci. 2015;40(4):362-6. PMid:26170524.
14 Sais G, Vidaller A, Jucgla A, Servitje O, Condom E, Peyri J. Prognostic factors in leukocytoclastic vasculitis: a clinicopathologic study of 160 patients. Arch Dermatol. 1998;134(3):309-15.
15 Einhorn J, Levis JT. Dermatologic diagnosis: Leukocytoclastic Vasculitis. Perm J. 2015;19(3):77-8. PMid:26176572.
16 Cakiter AU, Kucuk OS, Ozkaya DB, Topukcu B, Onsun N. Demographic characteristics, aetiology, and assessment of treatment options in leukocytoclastic vasculitis. Postepy Dermatol Alergol. 2017;34(2):104-9.
17 Jennette JC, Falk RJ, Andrassy K, et al. Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum. 1994;37(2):187-92.
18 Ghersetich I, Comacchi C, Jorizzo JL, Katsambas A, Lotti TM. Proposal for a working classification of cutaneous vasculitis. Clin Dermatol. 1999;17(5):499-503.
19 Fiorentino DF. Cutaneous vasculitis. J Am Acad Dermatol. 2003;48(3):311-40.
20 Loricera J, Calvo-Rio V, Mata C, et al. Urticarial vasculitis in northern Spain: clinical study of 21 cases. Medicine (Baltimore). 2014;93(1):53-60.
21 Silva LS, Campos KV, Melo AK, Brito DC, Braz AS, Freire EA. Rituximab as an alternative for patients with severe systemic vasculitis refractory to conventional therapy: report of seven cases and literature review. Rev Bras Reumatol. 2015;55(6):531-5. PMid:26318692.