Dilek TEZCAN, Muhammet LİMON, Semral GÜLCEMAL, Sema YILMAZ

Lökositoklastik vaskülitli hastaların demografik, etyolojik ve klinik özellikleri tek merkez deneyimi

ÖZ Amaç: Lökositoklastik vaskülit, primer deri tutulumu ile seyreden, esas olarak post kapiller venülleri etkileyen bir küçük damar vaskülit formudur. Etiyolojide ilaçlar, enfeksiyonlar, maligniteler, sistemik inflamatuvar hastalıklar gibi çeşitli nedenler yer almaktadır. Ancak olguların bir kısmında neden saptanamamakta ve bu olgular idiyopatik olarak değerlendirilmektedir. Klinik olarak özellikle alt ekstremitelerde sınırlı palpe edilebilen purpuralar ile karakterize olup, nadiren yaygın tutulum da gözlenebilmektedir. Bu çalışmada, kliniğimizde lökositoklastik vaskülit tanısı almış hastalarda etiyolojik faktörler, demografik ve klinik özelliklerin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya Ocak 2018 - Nisan 2019 arasında Romatoloji Bilim Dalında 2012 Uluslararası Chapel Hill Toplantısına göre lökositoklastik vaskülit tanısı konulan 40 hasta dahil edildi. Çalışmaya 18 yaş üstü hastalar dahil edildi. Hastaların epidemiyolojik, klinik, laboratuar bulguları ve tedavi bilgileri retrospektif olarak dosya kayıtları incelenerek elde edildi.Bulgular: Kırk hastanın (25 kadın, 15 erkek) yaş ortalaması 48.02±19.9 olduğu tespit edildi. Kutanöz lezyonlar en sık alt ekstremite yerleşimli, palpe edilebilen purpurik papül-plaklar şeklindeydi ve lezyonlara en sık eşlik eden semptomun kaşıntı olduğu saptandı. Hastaların %37.5 ’inde herhangi bir etyolojik neden saptanmamasına karşın, kalan hastaların %25’inde enfeksiyon ve/veya ilaç kullanımı öyküsü mevcuttu. Hastaların % 37.5’ine malignite ve romatizmal hastalık eşlik ediyordu. Sistemik kortikosteroidler en sık tercih edilen tedavi seçeneğiydi. Sonuç: Lökositoklastik vaskülit çoğunlukla ilaçlar ve enfeksiyon tarafından tetiklenen, malignite ve romatolojik hastalıkların da eşlik edebileceği iyi seyirli, kendi kendini sınırlayan bir hastalıktır. Altta yatan etiyolojinin belirlenmesi tedavide önemli bir basamak olmakla birlikte sistemik kortikosteroidler de etkin bir tedavi seçeneğidir.

Anahtar Kelimeler:

Lökositoklastik vaskülit, etyoloji

Demographic, etiological and clinical characteristics of patients with leukocytoclastic vasculitis single center experience

AbstractBackground/Aims:Methods:Results:Conclusions: ABSTRACT Background/Aims:Leukocytoclastic vasculitis is a small vessel vasculitis form which primarily affects the post capillary venules with primary skin involvement. Various causes such as drugs, infections, malignancies, systemic inflammatory diseases are included in etiology. However, some of the cases cannot be detected and these cases are evaluated as idiopathic.Clinically, it is characterized by limited palpable purpura at the lower extremities, and rarely a widespread involvement. In this study, we aimed to determine the etiologic factors, demographic and clinical characteristics of patients with leukocytoclastic vasculitis in our clinic.Material and Methods: Forty patients with leukocytoclastic vasculitis were included in the study between January 2018 and April 2019 according to the 2012 International Chapel Hill Meeting in the Department of Rheumatology. Epidemiological, clinical, laboratory findings and treatment information of the patients were obtained by examining the file records.Results: Forty patients (25 females, 15 males) were found to have a median age of 48.02 ± 19.9. Although no etiologic factor was found in 37,5% of the patients, 25% of the remaining patients had a history of infection and / or drug use, 37.5% of the patients were accompanied by malignancy and rheumatic disease Systemic corticosteroids were the most commonly used treatment options. Conclusion: Leukocytoclastic vasculitis is a well-functioning, self-limiting disease that can be accompanied by drugs and infection, malignancy and rheumatologic diseases. Defining the etiologic cause is an important step to therapy, while systemic corticosteroid are an effective therapeutic choice

Keywords:

Leukocytoclastic vasculitis, etiology,

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