Vancomycin-induced Henoch-Schönlein purpura: A case report

被引：10

作者：

Bataille S. ^{[1
]}

Daumas A. ^{[1
]}

Tasei A.-M. ^{[2
]}

Jourde-Chiche N. ^{[1
]}

Dussol B. ^{[1
]}

Burtey S. ^{[1
]}

Taugourdeau S. ^{[3
]}

Berland Y. ^{[1
]}

Chiche L. ^{[4
]}

机构：

[1] Centre de Néphrologie et Transplantation Rénale, Hôpital de la Conception, Université Aix-Marseille II, 13005 Marseille

[2] Laboratoire d'Anatomie Pathologique et Neuropathologie, Hôpital de la Timone, Université Aix-Marseille II, 13385 Marseille

[3] Centre Régional de Pharmacovigilance, Hôpital Salvator, Université Aix-Marseille II, 13274 Marseille

[4] Service de Médecine Interne, Hôpital de la Conception, Université Aix-Marseille II, 13005 Marseille

来源：

Journal of Medical Case Reports | / 6卷 / 1期

关键词：

Vancomycin; Vasculitis; Purpura; Teicoplanin; Macroscopic Hematuria;

D O I：

10.1186/1752-1947-6-106

中图分类号：

学科分类号：

摘要：

Introduction. Henoch-Schönlein purpura is a small-vessel systemic vasculitis. Although its exact pathophysiology remains unknown, Henoch-Schönlein purpura has been reported in association with various medical conditions including hypersensitivity. We report the case of a patient with vancomycin-induced Henoch-Schönlein purpura. Case presentation. A 42-year-old Caucasian man who had previously undergone a heart transplant was diagnosed as having an intra-abdominal abscess after he underwent a Hartmann procedure. At 15 days after initiation of antibiotic therapy including vancomycin, he developed a purpuric rash of the lower limbs, arthralgia, and macroscopic hematuria. At that time, our patient was already on hemodialysis for end-stage renal disease. Henoch-Schönlein purpura was diagnosed. After a second 15-day course of vancomycin, a second flare of Henoch-Schönlein purpura occurred. Skin biopsies showed leucocytoclastic vasculitis with IgA deposits and eosinophils in the peri-capillary inflammatory infiltrate, suggesting an allergic mechanism. After vancomycin was stopped, we did not observe any further flares. Only five cases of isolated cutaneous vasculitis, one case of lupus-like syndrome and one case of Henoch-Schönlein purpura after vancomycin treatment have been described to date in the literature. Conclusions: Clinicians should be aware that systemic vasculitis can be induced by some treatments. Vancomycin is a widely prescribed antibiotic. Occurrence of rare but serious Henoch-Schönlein purpura associated with vancomycin requires its prompt discontinuation. © 2012 Bataille et al; licensee BioMed Central Ltd.

引用

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