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Drug-associated cutaneous vasculitis: study of 239 patients from a single referral center

Abstract: OBJECTIVE: The 2012 International Chapel Hill Consensus Conference on the Nomenclature of Vasculitides defined drug-associated immune complex vasculitis as a distinct entity included within the category of vasculitis associated with probable etiology. In the present study we assessed the clinical spectrum of patients with drug-associated cutaneous vasculitis (DACV). METHODS: Case records were reviewed of patients with DACV treated at a tertiary referral hospital over a 36-year period. A diagnosis of DACV was considered if the drug was taken within a week before the onset of the disease. RESULTS: From a series of 773 unselected cutaneous vasculitis cases, 239 patients (30.9%; 133 men and 106 women; mean age 36 yrs) were diagnosed with DACV. Antibiotics (n=149; 62.3%), mainly ß-lactams and nonsteroidal antiinflammatory drugs (NSAID; n=24; 10%) were the most common drugs. Besides skin lesions (100%), the most common clinical features were joint (51%) and gastrointestinal (38.1%) manifestations, nephropathy (34.7%), and fever (23.8%). The most remarkable laboratory data were increased erythrocyte sedimentation rate (40.2%), presence of serum cryoglobulins (26%), leukocytosis (24.7%), positive antinuclear antibodies (21.1%), anemia (18.8%), and positive rheumatoid factor (17.5%). Despite drug discontinuation and bed rest, 108 patients (45.2%) required medical treatment, mainly corticosteroids (n=71) or immunosuppressive drugs (n=7). After a median followup of 5 months, relapses occurred in 18.4% of patients, and persistent microhematuria or renal insufficiency in 3.3% and 5%, respectively. CONCLUSION: DACV is generally associated with antibiotics and NSAID. In most cases it has a favorable prognosis, although a small percentage of patients may develop residual renal damage.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: J Rheumatol. 2014 Nov;41(11):2201-7

Editorial: The Journal of Rheumatology Publishing Company Limited

 Año de publicación: 2014

Nº de páginas: 8

Tipo de publicación: Artículo de Revista

 DOI: 10.3899/jrheum.140390

ISSN: 0315-162X

Proyecto español: RD08/0075 ; RD12/0009/0013

Autores/as

ORTIZ SANJUÁN, FRANCISCO

RICARDO BLANCO ALONSO

PINA MURCIA, TRINITARIO

JOSE HECTOR FERNANDEZ LLACA

CALVO RÍO, VANESA

LORICERA, JAVIER