title: Leukocytoclastic vasculitis associated with clarithromycin.
abstract: OBJECTIVE
  To report a possible case of leukocytoclastic vasculitis associated with clarithromycin therapy.
  
  
  METHODS
  An 83-year-old white woman was prescribed clarithromycin for pneumonia. Six days after her initial presentation, she developed lesions on her palms. Clarithromycin was discontinued at that time. The following day she developed purpuric eccymotic nonblanching lesions that primarily appeared on the lower extremities, buttocks, and abdomen. Colonoscopy revealed generalized erythema and edema of the bowel mucosa. Gastroscopy revealed duodenitis and gastritis, but no bleeding or ulceration. Skin biopsy of the lesions was compatible with leukocytoclastic vasculitis. Renal function was not affected, although hematuria was noted. All symptoms resolved after drug withdrawal and a short course of corticosteroids.
  
  
  METHODS
  Searches were performed on MEDLINE, Embase, International Pharmaceutical Abstracts, and major adverse drug reaction databases to identify reports and articles discussing clarithromycin- and macrolide-induced leukocytoclastic vasculitis.
  
  
  CONCLUSIONS
  Leukocytoclastic vasculitis is one category of drug hypersensitivity reactions characterized by distinctive patterns of perivascular inflammation. The case described here is consistent with the diagnosis of leukocytoclastic vasculitis, and is similar to the other single published case report associated with clarithromycin.
  
  
  CONCLUSIONS
  Leukocytoclastic vasculitis induced by clarithromycin is a rare but serious potential adverse effect.
authors.affiliation: Department of Pharmacy Services, Mount Sinai Hospital, Toronto, Ontario, Canada. scott.gavura@utoronto.ca
authors.forename: S R
authors.initials: SR
authors.lastname: Gavura
authors.forename: S
authors.initials: S
authors.lastname: Nusinowitz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D017291:Clarithromycin / Q000009:adverse effects*; D004382:Duodenitis / Q000139:chemically induced; D005260:Female; D005756:Gastritis / Q000139:chemically induced; D006801:Humans; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000139:chemically induced*
chemical_list: D000900:Anti-Bacterial Agents; D017291:Clarithromycin