Vasculitis in systemic lupus erythematosus following intravenous immunoglobulin therapy.
We describe a 6-year-old female patient with systemic lupus erythematosus (SLE) manifested mainly as steroid-dependent thrombocytopenia who developed a vasculitic appearing rash on her palms and soles following treatment with intravenous immunoglobulin (IVIg) (1 gm/kg/infusion x 2, 1 day apart). Vascular occlusion resulting in ischemic gangrene of the fore and midfeet eventually developed, necessitating bilateral amputation. This and other side effects described in SLE indicate that exacerbation of SLE, with the possibility of vasculitis, may occur following IVIg therapy.
Hashkes
P J
PJ
William S. Rowe Division of Pediatric Rheumatology, Children's Hospital Medical Center, Cincinnati, Ohio 45229, USA.
Lovell
D J
DJ
D000671:Amputation, Surgical; D002648:Child; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000098:blood supply / Q000601:surgery; D005734:Gangrene / Q000209:etiology* / Q000601:surgery; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000009:adverse effects*; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000473:pathology / Q000628:therapy*; D013921:Thrombocytopenia / Q000150:complications / Q000473:pathology / Q000628:therapy*; D014657:Vasculitis / Q000139:chemically induced* / Q000150:complications / Q000473:pathology
D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous