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Cytotoxic Edema: Pathophysiology

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Related Experiment Videos

Paraneoplastic leukocytoclastic vasculitis.

M Rozenbaum1, J E Naschitz, I Rosner

  • 1Rheumatology Service (M.R., I.R.), Department of Medicine A (J.E.N.) and Department of Pathology (I.M., J.H.B.), Bnai-Zion Medical Center and the Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel.

Journal of Clinical Rheumatology : Practical Reports on Rheumatic & Musculoskeletal Diseases
|December 17, 2008
PubMed
Summary
This summary is machine-generated.

Cancer-associated vasculitis can manifest as purpura. This case highlights a lung adenocarcinoma linked to leukocytoclastic vasculitis, resolving after tumor resection.

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Area of Science:

  • Nephrology
  • Dermatology
  • Oncology

Background:

  • Leukocytoclastic vasculitis can present with systemic symptoms like purpura, hematuria, and proteinuria.
  • Recalcitrant vasculitis may indicate an underlying malignancy.
  • Cancer-associated vasculitis is a rare but significant paraneoplastic phenomenon.

Purpose of the Study:

  • To report a case of cancer-associated vasculitis.
  • To investigate the link between an occult malignancy and recurrent leukocytoclastic vasculitis.
  • To highlight the importance of searching for malignancy in patients with unexplained vasculitis.

Main Methods:

  • Clinical presentation of a 56-year-old woman with widespread purpura, hematuria, and proteinuria.
  • Skin biopsy confirming leukocytoclastic vasculitis.
  • Diagnostic workup for occult malignancy, leading to the discovery of a lung tumor.
  • Surgical resection of the pulmonary adenocarcinoma.
  • Long-term follow-up to assess recurrence of vasculitis and effect of treatment.

Main Results:

  • The patient presented with eruptive purpura, hematuria, and proteinuria, diagnosed as leukocytoclastic vasculitis.
  • Vasculitis symptoms showed transient improvement with corticosteroids but recurred upon tapering.
  • An asymptomatic, well-differentiated peripheral pulmonary adenocarcinoma was identified.
  • Following surgical resection of the lung tumor, the purpuric eruption resolved and did not recur, even without steroid therapy.

Conclusions:

  • This case demonstrates a strong association between pulmonary adenocarcinoma and leukocytoclastic vasculitis.
  • Surgical removal of the underlying malignancy led to complete remission of the vasculitis.
  • Cancer-associated vasculitis should be considered in the differential diagnosis of unexplained or recurrent vasculitis, prompting a thorough search for occult neoplasms.