A case of polymorphic leukocytoclastic vasculitis associated with renal neoplasia

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Abstract

Objective: to describe a clinical case of polymorphic leukocytoclastic vasculitis (PLCV) associated with renal neoplasia.

Materials and methods. Patient K., a man, 67 y. o., was admitted to the surgical department No. 2 of the N. I. Pirogov State Clinical Hospital No. 1 with cardiac complaints and heart failure decompensation symptoms, severe respiratory insufficiency associated right lower lobe pneumonia. Besides cardiac function evaluation and pneumonia managing there was a conducting of differential diagnostic search to clarify the genesis of ulcerative necrotic rashs among systemic vasculitis, paraneoplastic syndrome including hematologic problems and sepsis.

Results. It was no data for systemic connective tissue diseases and systemic vasculitis during clinical examination and immunological diagnostics. On contrast-enhanced multispiral computed tomography of abdomen and retroperitoneal space there was latent malignant neoplasia of left kidney Т2аN1M0. PLCV was considered to paraneoplastic syndrome associated with malignancy. Due to the progression of vasculitis and the patient’s refusal of surgical treatment was prescribed GC 0.5 mg / kg / day as a result positive dynamics was noted.

Conclusion. This clinical case demonstrates necessity of providing examination aimed at malignancy excluding for early neoplasm’s detecting for patients with vasculitis.

About the authors

A. A. Klimenko

N.I. Pirogov Russian National Research Medical University

Author for correspondence.
Email: aaklimenko@yandex.ru
ORCID iD: 0000-0002-7410-9784

Alesya Aleksandrovna Klimenko

1 Ostrovityanova St., Moscow 117997

Russian Federation

N. A. Shostak

N.I. Pirogov Russian National Research Medical University

ORCID iD: 0000-0003-4669-1006

1 Ostrovityanova St., Moscow 117997

Russian Federation

A. S. Gaffarova

N.I. Pirogov Russian National Research Medical University

ORCID iD: 0000-0001-8757-9585

1 Ostrovityanova St., Moscow 117997

Russian Federation

A. A. Kondrashov

N.I. Pirogov Russian National Research Medical University

ORCID iD: 0000-0001-9152-3234

1 Ostrovityanova St., Moscow 117997

Russian Federation

E. I. Schmidt

N.I. Pirogov Russian National Research Medical University; N.I. Pirogov City Clinical Hospital No. 1

ORCID iD: 0000-0001-8814-9704

1 Ostrovityanova St., Moscow 117997

8 Lenin Ave., Moscow 119049

Russian Federation

References

  1. Park H.J., Ranganathan P. Neoplastic and paraneoplastic vasculitis, vasculopathy, and hypercoagulability. Rheum Dis Clin North Am 2011;37(4):593–606. doi: 10.1016/j.rdc.2011.09.002
  2. Baigrie D., Bansal P., Goyal A. et al. Leukocytoclastic Vasculitis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482159/
  3. Wick M.R, Patterson J.W. Cutaneous paraneoplastic syndromes. Semin Diagn Pathol 2019;36(4):211–28. doi: 10.1053/j.semdp.2019.01.001
  4. Dvoryankova Ye.V., Nevozinskaya Z.A., Sakaniya L.R., Korsunskaya I.M. Leukocytoclastic Vasculitis. Effektivnaya farmakoterapiya = Effective pharmacotherapy 2019;15(35):20–4. (In Russ.) doi: 10.33978/2307-3586-2019-15-35-20-24
  5. Clinical guidelines. Cutaneous Vasculitis / Russian Society of Dermatologists and Cosmetologists. Moscow, 2020. (In Russ.).
  6. Younger D.S., Carlson A. Dermatologic Aspects of Systemic Vasculitis. Neurol Clin 2019;37(2):465–73. doi: 10.1016/j.ncl.2019.01.017
  7. Younis A.A. Urticarial vasculitis as an initial manifestation of colonic carcinoma: a case report and review of the literature. Reumatismo 2018;70(4):259–63. doi: 10.4081/reumatismo.2018.1052
  8. Azar L., Khasnis A. Paraneoplastic rheumatologic syndromes. Curr Opin Rheumatol 2013;25(1):44–9. doi: 10.1097/BOR.0b013e328359e780
  9. Fain O., Hamidou M., Cacoub P. et al. Vasculitides associated with malignancies: analysis of sixty patients. Arthritis Rheum 2007;57(8):1473–80. doi: 10.1002/art.23085
  10. Buggiani G., Krysenka A., Grazzini M. et al. Paraneoplastic vasculitis and paraneoplastic vascular syndromes. Dermatol Ther 2010;23(6):597–605. doi: 10.1111/j.1529-8019.2010.01367.x
  11. Solans-Laqué R, Bosch-Gil JA, Pérez-Bocanegra C. et al. Paraneoplastic vasculitis in patients with solid tumors: report of 15 cases. J Rheumatol. 2008;35(2):294–304. PMID: 18085729
  12. Podjasek J.O., Wetter D.A., Pittelkow M.R., Wada D.A. Cutaneous small-vessel vasculitis associated with solid organ malignancies: the Mayo Clinic experience, 1996 to 2009. J Am Acad Dermatol 2012;66(2):e55–e65. doi: 10.1016/j.jaad.2010.09.732
  13. Arvinius C., González-Pérez A., García-Coiradas J. et al. Paraneoplastic vasculitis associated to pelvic chondrosarcoma: a case report. SICOT J 2016;2:8. doi: 10.1051/sicotj/2015042
  14. Tsimafeyeu I., Leonenko V., Kuznetsov V. et al. Paraneoplastic vasculitis in patients with metastatic renal cell carcinoma. Cancer Rep (Hoboken) 2019;2(2):e1142. doi: 10.1002/cnr2.1142
  15. Loricera J., Calvo-Río V., Ortiz-Sanjuán F. et al. The spectrum of paraneoplastic cutaneous vasculitis in a defined population: incidence and clinical features. Medicine (Baltimore). 2013;92(6):331–43. doi: 10.1097/MD.0000000000000009

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СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
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