Leukocytoclastic vasculitis with severe cardiac involvement in an infant: a case report.
Severe visceral involvement in leukocytoclastic vasculitis is rare. We report here the case of a 2-month-old male infant with leukocytoclastic vasculitis who initially presented with fever and skin purpura. Endomyocarditis with mitral valve regurgitation, multiple hepatic infarction, and pulmonary hemorrhage developed later. The patient was successfully managed with an aggressive treatment of high frequency oscillation ventilation and extracorporeal membrane oxygenation together with corticosteroid and azathioprine therapy for 3 months. Valvuloplasty was also performed due to irreversible damage of the mitral valve, although long-term oral anticongestive medications were also needed.
Hung
Jui-Tsung
JT
Department of Pediatrics, National Taiwan University Hospital, No. 7 Chung San South Road, Taipei, Taiwan, Republic of China.
Yang
Yao-Hsu
YH
Hsiao
Cheng-Hsiang
CH
Yu
Hsin-Hui
HH
Lee
Jyh-Hong
JH
Wang
Li-Chieh
LC
Chiang
Bor-Luen
BL
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D002404:Catheterization; D015199:Extracorporeal Membrane Oxygenation; D006612:High-Frequency Ventilation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D008297:Male; D008944:Mitral Valve Insufficiency / Q000209:etiology* / Q000628:therapy; D009205:Myocarditis / Q000209:etiology*; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000150:complications* / Q000188:drug therapy
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D001379:Azathioprine