title: Cutaneous vasculitis after renal transplantation: a case report.
abstract: BACKGROUND
  Cutaneous vasculitis is a rare symptom after renal transplantation. With a broad spectrum of differential diagnosis, the new appearance of a skin rash in transplanted patients can be challenging.
  
  
  METHODS
  We present the case of a 69-year-old man with palpable purpura, skin ulcerations, and diffuse arthralgias. He had a history of cadaveric renal transplantation owing to biopsy-proven isolated immunoglobulin (Ig)A nephropathy and never suffered from any skin manifestation before. Skin biopsy confirmed Henoch-Schoenlein purpura (HSP), which developed under maintenance immunsuppressive therapy with tacrolimus and mycophenolate mofetil. Renal biopsy showed recurrent IgA nephropathy with positive mesangial and capillary IgA staining.
  
  
  CONCLUSIONS
  This is the first case to describe a new manifestation of HSP following renal transplantation owing to isolated IgA nephropathy. Here, we summarize the differential diagnosis of cutaneous vasculitis following renal transplantation. Moreover we give a short review of the recurrence of IgA nephropathy and HSP after renal transplantation followed by possible strategies for prevention and therapy of recurrent disease.
authors.affiliation: Department I of Internal Medicine, Nephrology Division, Ludwig Maximilians University, Munich, Germany. Simon.Rau@med.uni-muenchen.de
authors.forename: S
authors.initials: S
authors.lastname: Rau
authors.forename: A
authors.initials: A
authors.lastname: Wollenberg
authors.forename: M
authors.initials: M
authors.lastname: Weiss
authors.forename: M
authors.initials: M
authors.lastname: Fischereder
authors.forename: U
authors.initials: U
authors.lastname: Schönermarck
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005076:Exanthema / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D005922:Glomerulonephritis, IGA / Q000175:diagnosis / Q000276:immunology / Q000601:surgery*; D006801:Humans; D011695:IgA Vasculitis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D007070:Immunoglobulin A / Q000032:analysis*; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007668:Kidney / Q000187:drug effects / Q000276:immunology* / Q000473:pathology; D016030:Kidney Transplantation / Q000009:adverse effects / Q000276:immunology*; D008297:Male; D011237:Predictive Value of Tests; D012008:Recurrence; D012867:Skin / Q000187:drug effects / Q000276:immunology* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D007070:Immunoglobulin A; D007166:Immunosuppressive Agents