Jale YÜKSEK, Hüseyin Şener BARUT, Engin SEZER, Özgür GÜNAL

Lymphocytic vasculitis developing after Hepatitis A vaccine and successful treatment with Nadroparin Calcium

Vaskülitlerin pek çok türü vardır, en yaygın olanı postkapiller venülleri tutan küçük damarvaskülitleridir. Etiyolojisinde ilaçlar, enfeksiyöz ajanlar, kan hastalıkları, neoplaziler ve romatoidhastalıklar yer almaktadır. Bu raporda inaktif Hepatit B taşıyıcısı olarak izlenen bir hastada HepatitA aşısı sonrası gelişen lenfositik vaskülit vakası sunulmaktadır. Hasta, Hepatit A aşısı yapıldıktanyirmi gün sonra her iki kol ve dirsekte, dağınık yerleşimli, çok sayıda kırmızı-mor renkli lezyonlarnedeniyle polikliniğimize başvurdu. Hastanın karaciğer fonksiyon testleri, üresi, tam kan sayımı,sedimentasyon ve C-reaktif protein değerleri normaldi. Hastanın el dorsumundan alınan deribiyopsi örneğinin patoloji sonucu lenfositik vaskülit olarak tanımlandı. Nadroparin kalsiyum2x0.4ml subkutan uygulama ile hastanın lezyonlarında 4 hafta içinde tam iyileşme sağlandı. Sonuçolarak lenfositik vaskülit ayırıcı tanısında hekimlerin Hepatit A aşısı yan etkisini de göz önündebulundurması gerekmektedir.

Hep atit A aşısı sonrası gelişen Lenf ositik vaskülit ve Nadrop arin Kalsiyum ile başarılı tedavisi

Among the various types of vasculitis, the most common is small vessel vasculitis involving thepost capillary venules. Etiological factors are drugs, infectious agents, blood disorders,malignancies and rheumatological disorders. In this report, a Hepatitis B virus (HBV) carrierpatient who experienced lymphocytic vasculitis after vaccination for Hepatitis A is presented. Onadmission, the patient had desquamated red-purple rashes with the dimension of approximately 2- 3cm, scattered on both arms and elbows. The lesions appeared 20 days after the Hepatitis Avaccine. Liver function tests, complete blood count, erythrocyte sedimentation rate, blood ureanitrogen and serum C-reactive protein levels were within normal ranges. Pathology of the skinbiopsy taken from the dorsum of hand was consistent with lymphocytic vasculitis. With thesubcutaneous Nadroparin calcium (2x0.4ml) treatment, the patient recovered completely in fourweeks. In conclusion, physicians should also consider the adverse effect of hepatitis A vaccine inthe differential diagnosis of lymphocytic vasculitis

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