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Bilateral breast necrotizing leukocytoclastic vasculitis: First case report
Hassan Baig1, Wen Ling Choong2, Pei Ru Chew3
1Department of General Surgery, Ninewells Hospital and Medical School, Dundee, UK.
The Breast Journal
|November 28, 2021
Summary
Leukocytoclastic vasculitis (LCV), a rare small vessel disease, can manifest as necrotizing breast conditions in patients treated with glatiramer acetate for multiple sclerosis. Prompt multidisciplinary intervention is crucial for managing this life-threatening complication.
Area of Science:
- Immunology
- Dermatology
- Neurology
Background:
- Leukocytoclastic vasculitis (LCV) is an immune complex-mediated small vessel vasculitis.
- Glatiramer acetate is a common treatment for multiple sclerosis.
- Necrotizing LCV of the breast is an extremely rare presentation.
Observation:
- A 48-year-old woman with multiple sclerosis on glatiramer acetate developed rapidly progressing necrotizing bilateral breast LCV.
- The condition necessitated bilateral mastectomies and debridement of the anterior abdominal wall.
- This case highlights a severe, potentially life-threatening adverse reaction to glatiramer acetate.
Findings:
- The patient's necrotizing LCV was associated with glatiramer acetate therapy for multiple sclerosis.
- Surgical intervention was required to manage the extensive tissue necrosis.
- This underscores the importance of recognizing rare LCV presentations.
Implications:
- Clinicians should consider LCV in patients on glatiramer acetate presenting with unexplained skin necrosis.
- Early recognition and a multidisciplinary approach are vital for optimal patient outcomes.
- Further research may be needed to elucidate the specific mechanisms linking glatiramer acetate to LCV.
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