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Alqatari S, Hasan M, Bukhari R, Hadhiah K, Alwaheed A, Alabdrabalnabi F, Al Ohaid F, Aldarwish AW. A young female with hypocomplementemic urticarial vasculitis associated with a rare CNS manifestation. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2023. [DOI: 10.29333/ejgm/12859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
This case report represents a rare case of 14-year-old female who diagnosed with hypocompementemic urticarial vasculitis syndrome that presents with glomerulonephritis, diffuse alveolar hemorrhage, and acute disseminated encephalomyelitis. The progression of the symptoms explained in the text below in which the final diagnosis was reached after a challenging approach. Patient was managed properly and followed up after treating with rituximab, although she represents no sign of the disease after a total of two cycles.
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Affiliation(s)
- Safi Alqatari
- Internal Medicine and Rheumatology, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, SAUDI ARABIA
| | - Manal Hasan
- Internal Medicine and Rheumatology, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, SAUDI ARABIA
| | - Raed Bukhari
- Internal Medicine and Rheumatology, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, SAUDI ARABIA
| | - Kawther Hadhiah
- Neurology, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, SAUDI ARABIA
| | - Abrar Alwaheed
- Internal Medicine and Hematology, King Fahad University Hospital, Imam Abdulrahman Bin Faisal University, Dammam, SAUDI ARABIA
| | | | - Fatimah Al Ohaid
- General Medicine, Saud Al Babtain Cardiac Hospital, Dammam, SAUDI ARABIA
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Bastelica P, Labetoulle M, Noel N, Barreau E, Matonti F, Jourde Chiche N, Rousseau A, Benichou J. [Retinal involvement in hypocomplementemic urticarial vasculitis (McDuffie syndrome): Report of two cases]. J Fr Ophtalmol 2021; 44:e587-e590. [PMID: 34452765 DOI: 10.1016/j.jfo.2021.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 01/16/2021] [Accepted: 02/01/2021] [Indexed: 11/29/2022]
Affiliation(s)
- P Bastelica
- Service d'ophtalmologie, hôpital Bicêtre, université Paris-Sud, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - M Labetoulle
- Service d'ophtalmologie, hôpital Bicêtre, université Paris-Sud, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Department of Immunology of viral and auto-immune disease (IMVA DSV, iMETI, IDMIT), UMR1184, CEA, 18, route du Panorama, 92260 Fontenay-aux-Roses, France
| | - N Noel
- Department of Immunology of viral and auto-immune disease (IMVA DSV, iMETI, IDMIT), UMR1184, CEA, 18, route du Panorama, 92260 Fontenay-aux-Roses, France; Service d'immunologie clinique, hôpital Bicêtre, université Paris-Sud, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - E Barreau
- Service d'ophtalmologie, hôpital Bicêtre, université Paris-Sud, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - F Matonti
- Centre Monticelli Paradis, 433bis rue Paradis, 13008 Marseille, France; Université Aix-Marseille, CNRS, INT, Institut de neurosciences de la Timone, 27, boulevard Jean-Moulin, 13385 Marseille cedex 05, France
| | - N Jourde Chiche
- Université Aix-Marseille, C2VN, Inserm, INRA ; centre de néphrologie et transplantation rénale, hôpital de la Conception, 147, boulevard Baille, 13005 Marseille, France
| | - A Rousseau
- Service d'ophtalmologie, hôpital Bicêtre, université Paris-Sud, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France; Department of Immunology of viral and auto-immune disease (IMVA DSV, iMETI, IDMIT), UMR1184, CEA, 18, route du Panorama, 92260 Fontenay-aux-Roses, France
| | - J Benichou
- Service d'ophtalmologie, hôpital Bicêtre, université Paris-Sud, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France.
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Gu SL, Jorizzo JL. Urticarial vasculitis. Int J Womens Dermatol 2021; 7:290-297. [PMID: 34222586 PMCID: PMC8243153 DOI: 10.1016/j.ijwd.2021.01.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 12/23/2020] [Accepted: 01/21/2021] [Indexed: 01/19/2023] Open
Abstract
Urticarial vasculitis is a rare clinicopathologic entity that is characterized by chronic or recurrent episodes of urticarial lesions. Skin findings of this disease can be difficult to distinguish visually from those of chronic idiopathic urticaria but are unique in that individual lesions persist for ≥24 hours and can leave behind dusky hyperpigmentation. This disease is most often idiopathic but has been linked to certain drugs, infections, autoimmune connective disease, myelodysplastic disorders, and malignancies. More recently, some authors have reported associations between urticarial vasculitis and COVID-19, as well as influenza A/H1N1 infection. Urticarial vasculitis can extend systemically as well, most often affecting the musculoskeletal, renal, pulmonary, gastrointestinal, and ocular systems. Features of leukocytoclastic vasculitis seen on histopathologic examination are diagnostic of this disease, but not always seen. In practice, antibiotics, dapsone, colchicine, and hydroxychloroquine are popular first-line therapies, especially for mild cutaneous disease. In more severe cases, immunosuppressives, including methotrexate, mycophenolate mofetil, azathioprine, and cyclosporine, as well as corticosteroids, may be necessary for control. More recently, select biologic therapies, including rituximab, omalizumab, and interleukin-1 inhibitors have shown promise for the treatment of recalcitrant or refractory cases.
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Affiliation(s)
- Stephanie L. Gu
- Department of Dermatology, Weill Cornell Medicine, New York, NY, United States
- Corresponding author.
| | - Joseph L. Jorizzo
- Department of Dermatology, Weill Cornell Medicine, New York, NY, United States
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC, United States
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Navarro-Navarro I, Jiménez-Gallo D, Villegas-Romero I, Linares-Barrios M. Use of omalizumab in the treatment of hypocomplementemic urticarial vasculitis. Dermatol Ther 2020; 33:e13237. [PMID: 32012397 DOI: 10.1111/dth.13237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Irene Navarro-Navarro
- Unidad de Gestión Clínica de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - David Jiménez-Gallo
- Unidad de Gestión Clínica de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Isabel Villegas-Romero
- Unidad de Gestión Clínica de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Mario Linares-Barrios
- Unidad de Gestión Clínica de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Puerta del Mar, Cádiz, Spain
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Boyer A, Gautier N, Comoz F, Hurault de Ligny B, Aouba A, Lanot A. [Nephropathy associated with hypocomplementemic urticarial vasculitis: A case report and literature review]. Nephrol Ther 2020; 16:124-135. [PMID: 31928955 DOI: 10.1016/j.nephro.2019.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/08/2019] [Accepted: 09/01/2019] [Indexed: 11/25/2022]
Abstract
Hypocomplementemic urticarial vasculitis is a rare systemic vasculitis, affecting small vessels, characterised by chronicle urticaria, hypocomplementemia, and systemic manifestations. Renal involvement, whose prevalence varies between 9% and 60%, is mainly glomerular. We here report the case of a 59 years old woman presenting kidney failure, associated with chronicle urticaria and arthralgias. Laboratory investigation showed haematuria, proteinuria, hypocomplementemia and anti-SSa antibody positivity. A percutaneous kidney biopsy revealed focal and segmental glomerulonephritis associated with an acute interstitial nephritis. Hypocomplementemic urticarial vasculitis diagnosis was established after identifying anti-C1q antibodies. The lack of a dry syndrome, the negativity of a Schirmer test and the lack of sialadenitis on a salivary gland biopsy excluded an associated Gougerot-Sjögren Syndrome. The patient was treated with hydroxychloroquine and low-dose steroids, enabling a clinical and biological recovery. Of the 82 cases in the literature describing hypocomplementemic urticarial vasculitis associated nephropathies, 72 (88%) were a glomerular impairment, most frequently secondary to membranoproliferative glomerulonephritis. Only 6 (7%) tubulo-interstitial nephritis have been reported, 4 of them being associated with a glomerulonephritis. Patients were more likely to be women, aged in their third decade. The most frequent renal manifestations were haematuria (60%), and proteinuria (52%). Kidney failure was rarely observed (22%), with a fairly good renal prognosis. Hypocomplementemic urticarial vasculitis was associated with a systemic disease in 11 (13%) patients. In the absence of recommendations, the treatment strategy remains to be defined.
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Affiliation(s)
- Annabel Boyer
- Centre universitaire des maladies rénales, CHU de Caen, avenue de la côte de Nacre, 14033 Caen cedex 9, France; Unicaen, UFR de médecine, Normandie Université, 2, rue des Rochambelles, 14032 Caen cedex, France
| | - Nicolas Gautier
- Centre universitaire des maladies rénales, CHU de Caen, avenue de la côte de Nacre, 14033 Caen cedex 9, France; Unicaen, UFR de médecine, Normandie Université, 2, rue des Rochambelles, 14032 Caen cedex, France
| | - François Comoz
- Service d'anatomopathologie, CHU de Caen, avenue de la côte de Nacre, 14033 Caen cedex 9, France
| | - Bruno Hurault de Ligny
- Centre universitaire des maladies rénales, CHU de Caen, avenue de la côte de Nacre, 14033 Caen cedex 9, France; Unicaen, UFR de médecine, Normandie Université, 2, rue des Rochambelles, 14032 Caen cedex, France
| | - Achille Aouba
- Service de médecine interne, CHU de Caen, avenue de la côte de Nacre, 14033 Caen cedex 9, France
| | - Antoine Lanot
- Centre universitaire des maladies rénales, CHU de Caen, avenue de la côte de Nacre, 14033 Caen cedex 9, France; Unicaen, UFR de médecine, Normandie Université, 2, rue des Rochambelles, 14032 Caen cedex, France.
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Gomes De Pinho Q, Brue A, Kaplanski G, Granel B, Benyamine A. Efficacité du rituximab dans le traitement de la vascularite urticarienne hypocomplémentémiante à propos d’une observation. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Raboudi A, Litaiem N, Jones M, Zeglaoui F. Hypocomplementemic urticarial vasculitis occurring in a patient with relapsing polychondritis. Int J Dermatol 2018; 57:1363-1364. [PMID: 29779215 DOI: 10.1111/ijd.14051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Accepted: 04/23/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Asma Raboudi
- University of Tunis El Manar, Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Noureddine Litaiem
- University of Tunis El Manar, Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Meriem Jones
- University of Tunis El Manar, Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia
| | - Faten Zeglaoui
- University of Tunis El Manar, Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia
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