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Urticarial Vasculitis Associated With Levothyroxine.

Mark Metry¹, Abdel Rahem S Yusuf¹, Jason Lane²

¹Internal Medicine, Cleveland Clinic Akron General, Akron, USA.

|July 24, 2023

Summary

Urticarial vasculitis, a skin condition, can be triggered by medications. In a rare case, thyroid replacement therapy, not the underlying thyroiditis, caused urticarial vasculitis in a patient.

Keywords:

hypothyroid hypothyroidism leukocytoclastic levothyroxine thyroiditis urticarial vasculitis

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Area of Science:

Immunology
Dermatology
Endocrinology

Background:

Urticarial vasculitis (UV) is an inflammatory condition with diverse etiologies, often presenting idiopatically.
Standard treatments include corticosteroids and immunosuppressants.
Identifying and addressing the underlying cause is crucial for resolving symptoms.

Observation:

This case report details a patient experiencing UV.
The patient's UV was triggered by thyroid hormone replacement therapy.
The underlying condition necessitating treatment was Hashimoto's thyroiditis.

Findings:

Hashimoto's thyroiditis can independently cause UV.
In this specific case, thyroid replacement therapy, not Hashimoto's thyroiditis itself, acted as the trigger for UV.
This represents an unusual presentation of medication-induced UV.

Implications:

Highlights the importance of considering medication side effects in UV etiology.
Suggests a need for careful evaluation of all medications, including hormone replacement, in patients with UV.
Underscores the complex relationship between autoimmune thyroid disease and inflammatory conditions.