#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Cutaneou vasculitis in SLE – to treat or not to treat?


Authors: M. Gregová
Authors‘ workplace: Revmatologický ústav Praha
Published in: Čes. Revmatol., 28, 2020, No. 2, p. 110-115.
Category: Case Report

Overview

Systemic lupus erythematosus (SLE) is a disease with large variability in clinical manifestations. In present work we describe case of a young woman with SLE with multiple skin vasculitic lesions. We show how difficult can the treatment of cutaneous vasculitis be. Skin lesions have often necrotic bed, that attenuates bacterial superinfection and the decision on systemic immunosuppressive treatment accompanies mayor dilemma. Combination immunosuppressive therapy is also hazardous due to possible serious adverse effects; the therapy may worsen
underlining hematologic abnormalities that often 
accompany SLE. Nevertheless vasculitis is manifesta-
tion of systemic disease activity and therefor only adequate therapy leads to resolution of cutaneous vasculitic lesion.

Keywords:

Cyclophosphamide – Systemic lupus erythematosus – cutaneous vasculitis – leucopenia


Sources

1. Ramos-Casals M, Nardi N, Lagrutta M, Brito-Zerón P, Bové A, Delgado G, et al. Vasculitis in systemic lupus erythematosus: Prevalence and Clinical Characteristics in 670 patients. Medicine 2006; 85: 95–104.

2. Callen JP, Kingman J. Cutaneous vasculitis in systemic lupus erythematosus. A poor prognostic indicator. Cutis 1983; 32: 433–436.

3. Gheita TA, Abaza NM, Sayed S, El-Azkalany GS,  Fishawy HS,  Eissa AH. Cutaneous vasculitis in systemic lupus erythematosus patients: potential key player and implications. Lupus 2017; 1: 1–6.

4. Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics criteria for systemic lupus erythematosus. Arthritis Rheumatol 2012; 64: 2677–2686.

5. Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, Ramsey-Goldman R, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Ann Rheum Dis 2019; 78: 1151–1159.

6. Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, Ramsey-Goldman R, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Arthritis Rheumatol 2019; 71: 1400–1412.

7. Drenkard C, Villa AR, Reyes E, Abello M, Alarcón-Segovia D. Vasculitis in systemic lupus erythematosus. Lupus 1997; 6: 235–242.

8. Praprotnik S, Blank M, Meroni PL, Rozman B, Eldor A, Shoenfeld Y. Classification of anti-endothelial cell antibodies into antibodies against microvascular and macrovascular endothelial cells. Arthritis Rheum 2001; 44: 1484–1494.

9. Galeazzi M, Morozzi G, Sebastiani GD, Bellisai F, Marcolongo R, Cerveraet R, et al. Antineutrophil cytoplasmatic antibodies in 566 European patients with systemic lupus erythematosus: prevalence, clinical associations and correlation with other autoantibodies. Clin Exp Rheumatol 1998; 16: 541–546.

10. Mansi IA, Opran A, Rosner F. ANCA-associated small vessel vasculitis. Am Fam Physician 2002; 65: 1615–1620.

11. Muangchan Ch, van Vollenhoven RF, Bernatsky RS, Douglas Smith C, Hudson M, Inanc M, et al. Treatment algorithms in systemic lupus erythematosus. Arthritis Care Res 2015; 67: 1237–1245.

12. Fanouriakis A, Kostopoulou M, Alunno A, Aringer M, Bajema I, Cervera R, et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis 2019; 78: 736–745.

Labels
Dermatology & STDs Paediatric rheumatology Rheumatology
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#