Leukocytoclastic Vasculitis as Presenting Manifestation of Chronic Hepatitis B Virus Infection View PDF

Javier A Cavallasca
Medicine, Section Of Rheumatology And Systemic Autoimmune Diseases, JB Iturraspe Hospital, Santa Fe, Argentina

Published on: 2024-09-23

Abstract

Leukocytoclastic vasculitis, also called leukocytoclastic cutaneous angiitis, is the most common form of vasculitis. Although most cases are idiopathic, etiologic agents include infectious agents, connective tissue diseases, drug hypersensitivity reactions, and solid or hematologic malignancies. Although infectious processes are a known cause of leukocytoclastic vasculitis, hepatitis B virus (HBV) infection is very rare. We present a 47-year-old woman, with no previous pathologic history, who consulted for arthralgias in the knees and ankles, myalgia’s and purpuric rash with mild pruritus in both lower limbs, of one month evolution. Skin biopsy of lower extremity lesions was compatible with leukocytoclastic vasculitis. Hepatitis B serology was positive, so she started antiviral treatment with tenofovir and prednisone with good evolution of her skin lesions.

Keywords

Vasculitis, Hepatitis B virus

Introduction

Leukocytoclastic vasculitis, also called leukocyocytoclastic cutaneous hostitis according to the revised nomenclature of the 2012 Chapel Hill consensus conference, is characterized by the inflammation of the blood vessels of small caliber, usually post-channel venules. The inflammatory infiltrate can be neutrophilic, lymphocyte or granulomatous. Neutrophils suffer degeneration or leukocytoclasia giving rise to the so-called nuclear dust. It is the most common form of vasculitis with an approximate incidence of 45 million annual cases the Worldwide, it is more frequent in adults and slightly more in women [1].