Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.190072
Jornal Vascular Brasileiro
Case Report

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

Downloads: 0
Views: 158

Resumo

Resumo: Paciente do sexo feminino, 46 anos de idade, procurou o pronto socorro do Hospital Municipal Universitário apresentando lesões necróticas em membros inferiores associadas à síndrome consumptiva. Após anamnese e exame físico, obteve-se o diagnóstico de vasculite leucocitoclástica de modo imediato e econômico por meio da utilização de algoritmo específico de vasculites primárias, permitindo início precoce da terapêutica adequada. A boa evolução do quadro clínico ratificou a necessidade de se obter diagnóstico definitivo e início rápido da terapêutica.

Palavras-chave

leucocitoclasia, cutânea, algoritmos, diagnóstico, vasculite

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

eukocytoclastic; cutaneous; algorithms; diagnosis; vasculitis

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. http://dx.doi.org/10.1002/art.37715. PMid:23045170.

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. http://dx.doi.org/10.1016/S0738-081X(99)00059-0. PMid:10590845.

5 Arvan ME, Brodell RT. A palpable clue to vasculitis. Postgrad Med. 1999;105(3):229-32. http://dx.doi.org/10.3810/pgm.1999.03.656. PMid:10086045.

6 Rodrigues R, Jorge PT. Vasculite leucocitoclástica: uma rara manifestação associada ao metimazol. Arq Bras Endocrinol Metabol. 2002;46(6):716-9. http://dx.doi.org/10.1590/S0004-27302002000600017.

7 Bezerra AS, Polimanti AC, Fürst RVC, Corrêa JA. Algorithm for diagnosis of primary vasculitides. J Vasc Bras. 2019;18:e20180092. http://dx.doi.org/10.1590/1677-5449.009218.

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. http://dx.doi.org/10.1016/S0923-1811(00)00092-X. PMid:11084296.

9 Carlson JA. The histological assessment of cutaneous vasculitis. Histopathology. 2010;56(1):3-23. http://dx.doi.org/10.1111/j.1365-2559.2009.03443.x. PMid:20055902.

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. http://dx.doi.org/10.1016/j.mayocp.2014.04.015. PMid:24981218.

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. http://dx.doi.org/10.1111/j.1440-0960.2006.00239.x. PMid:16637802.

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. http://dx.doi.org/10.1097/00005792-199811000-00006. PMid:9854604.

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. http://dx.doi.org/10.1001/archderm.134.3.309. PMid:9521029.

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. http://dx.doi.org/10.5114/ada.2017.67071. PMid:28507487.

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. http://dx.doi.org/10.1002/art.1780370206. PMid:8129773.

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. http://dx.doi.org/10.1016/S0738-081X(99)00058-9. PMid:10590842.

19 Fiorentino DF. Cutaneous vasculitis. J Am Acad Dermatol. 2003;48(3):311-40. http://dx.doi.org/10.1067/mjd.2003.212. PMid:12637912.

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. http://dx.doi.org/10.1097/MD.0000000000000013. PMid:24378743.

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.
 

5e84cd400e8825283da14d48 jvb Articles

J Vasc Bras

Share this page
Page Sections