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An Unusual Timing of Amoxicillin-Induced IgA Vasculitis in an Elderly Patient

Immunoglobulin A vasculitis is a small vessel vasculitis which is usually common in the pediatric group. It is rare in adult population but more severe than in children. Proposed triggers include infections, malignancy and medications. For most part, the association is made when immunoglobulin A vas...

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Autores principales: Fohle, Emmanuel, Montgomery, Sean, Murat, Joseph, Ness, Rachel, Lo, Tze Shien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289393/
https://www.ncbi.nlm.nih.gov/pubmed/34290934
http://dx.doi.org/10.7759/cureus.15757
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author Fohle, Emmanuel
Montgomery, Sean
Murat, Joseph
Ness, Rachel
Lo, Tze Shien
author_facet Fohle, Emmanuel
Montgomery, Sean
Murat, Joseph
Ness, Rachel
Lo, Tze Shien
author_sort Fohle, Emmanuel
collection PubMed
description Immunoglobulin A vasculitis is a small vessel vasculitis which is usually common in the pediatric group. It is rare in adult population but more severe than in children. Proposed triggers include infections, malignancy and medications. For most part, the association is made when immunoglobulin A vasculitis develops within two weeks after starting the implicated medication. A 66-year-old male who was treated with amoxicillin/clavulanate for presumed right fourth toe infection but returned to the emergency department 48 hours later with palpable purpura of lower limbs, arthralgia with swollen hands and colicky abdominal pain with nausea. Abdominal computed tomography (CT) scan showed mildly dilated small bowel. Skin biopsies showed leukocytoclastic vasculitis with IgA deposit on immunofluorescence. The patient was treated with a short course of steroid and the rash was significantly reduced during subsequent follow-up. Although amoxicillin/clavulanate is widely prescribed, clinicians need to be aware of this risk and immediately stop it if signs of drug-induced vasculitis develop.
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spelling pubmed-82893932021-07-20 An Unusual Timing of Amoxicillin-Induced IgA Vasculitis in an Elderly Patient Fohle, Emmanuel Montgomery, Sean Murat, Joseph Ness, Rachel Lo, Tze Shien Cureus Dermatology Immunoglobulin A vasculitis is a small vessel vasculitis which is usually common in the pediatric group. It is rare in adult population but more severe than in children. Proposed triggers include infections, malignancy and medications. For most part, the association is made when immunoglobulin A vasculitis develops within two weeks after starting the implicated medication. A 66-year-old male who was treated with amoxicillin/clavulanate for presumed right fourth toe infection but returned to the emergency department 48 hours later with palpable purpura of lower limbs, arthralgia with swollen hands and colicky abdominal pain with nausea. Abdominal computed tomography (CT) scan showed mildly dilated small bowel. Skin biopsies showed leukocytoclastic vasculitis with IgA deposit on immunofluorescence. The patient was treated with a short course of steroid and the rash was significantly reduced during subsequent follow-up. Although amoxicillin/clavulanate is widely prescribed, clinicians need to be aware of this risk and immediately stop it if signs of drug-induced vasculitis develop. Cureus 2021-06-19 /pmc/articles/PMC8289393/ /pubmed/34290934 http://dx.doi.org/10.7759/cureus.15757 Text en Copyright © 2021, Fohle et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Dermatology
Fohle, Emmanuel
Montgomery, Sean
Murat, Joseph
Ness, Rachel
Lo, Tze Shien
An Unusual Timing of Amoxicillin-Induced IgA Vasculitis in an Elderly Patient
title An Unusual Timing of Amoxicillin-Induced IgA Vasculitis in an Elderly Patient
title_full An Unusual Timing of Amoxicillin-Induced IgA Vasculitis in an Elderly Patient
title_fullStr An Unusual Timing of Amoxicillin-Induced IgA Vasculitis in an Elderly Patient
title_full_unstemmed An Unusual Timing of Amoxicillin-Induced IgA Vasculitis in an Elderly Patient
title_short An Unusual Timing of Amoxicillin-Induced IgA Vasculitis in an Elderly Patient
title_sort unusual timing of amoxicillin-induced iga vasculitis in an elderly patient
topic Dermatology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8289393/
https://www.ncbi.nlm.nih.gov/pubmed/34290934
http://dx.doi.org/10.7759/cureus.15757
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