Resident Report 2/3 -Palpable Purpura

Teaching Pearls:

  • Common causes of palpable purpura (leukocytoclastic vasculitis)
    • Infections
      • HBV, HCV, HIV, etc
    • Medications
      • Commonly occurs 7-10 days after the initiation of a medications
      • Common culprit medications include penicillin, cephalosporin, NSAIDs, etc
    • Autoimmune disease (see below)
    • Malignancy
      • Paraneoplastic syndrome
  • Autoimmune Disease with palpable purpura
    • Granulomatosis Polyangiitis (Wegeners)
      • Hepatorenal syndrome with sinusitis
      • c-ANCA/anti-Pr-3 positive
    • Churg Strauss Syndrome
      • Associated with eosinophilia
      • p-ANCA positive
    • Microscopic polyangittis
      • p-ANCA positive
    • Cyroglobulinemic vasculitis
      • HCV positive
      • cryoglobin positive
    • HSP
      • palpable purpura with abdominal pain, arthralgia, renal involvement
      • Skin biopsy positive for LCV with IgA deposits


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