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Multisystemic leukocytoclastic vasculitis affecting the central nervous system.

Alper Soylu1, Salih Kavukçu, Bariş Erdur

  • 1Department of Pediatrics, Dokuz Eylül University, Faculty of Medicine, Izmir, Turkey.

Pediatric Neurology
|October 1, 2005
PubMed
Summary

Leukocytoclastic vasculitis, typically mild, can cause severe systemic issues. This case highlights rare central nervous system, lung, kidney, and GI involvement in a pediatric patient following an insect bite.

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Area of Science:

  • Pediatric vasculitis
  • Immunodermatology
  • Systemic autoimmune diseases

Background:

  • Leukocytoclastic vasculitis (LCV) is a small vessel vasculitis.
  • It is usually self-limiting with rare systemic complications.
  • Insect bites can trigger LCV.

Observation:

  • A 10-year-old male presented with LCV after an insect bite.
  • He exhibited cutaneous, central nervous system (CNS), pulmonary, renal, and gastrointestinal involvement.
  • Diagnosis was confirmed via histopathology of cerebral hematoma.

Findings:

  • The patient showed initial improvement with a multi-agent immunosuppressive protocol (steroids, cyclophosphamide, IVIG, plasmapheresis).
  • Despite treatment, the patient developed nosocomial sepsis.

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  • The patient ultimately succumbed to sepsis.

    • Implications:

    • This case underscores the potential for severe systemic LCV, even in pediatric patients.
    • Early recognition and aggressive management are crucial for LCV with systemic involvement.
    • The case highlights the risk of complications, including sepsis, in critically ill patients requiring intensive treatment.