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[A case of livedo vasculitis associated with mononeuritis multiplex]
Rinsho Shinkeigaku = Clinical Neurology
|June 10, 1998
Summary
Livedo vasculitis can lead to nerve damage (mononeuritis multiplex). Coagulation system alterations may play a role in this condition, with antithrombotic drugs showing therapeutic benefits.
Area of Science:
- Vascular Medicine
- Neurology
- Dermatology
Background:
- Livedo vasculitis presents as recurrent lower extremity livedo reticularis with skin vasculitis.
- Neurological complications are a potential, though less common, manifestation.
Observation:
- A 26-year-old female with a 7-year history of livedo vasculitis developed mononeuritis multiplex.
- She experienced sensorimotor deficits in median/ulnar nerves and sensory loss in peroneal nerves.
- Nerve biopsy showed fiber loss and vasculitic changes; steroids provided initial relief.
Findings:
- Recurrent neurological symptoms and painful skin ulcerations emerged despite steroid treatment.
- Elevated serum thrombin-antithrombin complex (TAT) levels were detected.
- Argatroban, an antithrombotic agent, significantly improved recurrent symptoms and skin lesions.
Implications:
- This case highlights a potential link between livedo vasculitis and the blood coagulation system.
- Findings suggest coagulation abnormalities may contribute to livedo vasculitis pathogenesis and its neurological sequelae.
- Antithrombotic therapy may be a valuable treatment option for managing complex livedo vasculitis cases.