Oxaliplatin-Induced Leukocytoclastic Vasculitis under Adjuvant Chemotherapy for Colorectal Cancer: Two Cases of a Rare Adverse Event.
Leukocytoclastic vasculitis is a multicausal systemic inflammatory disease of the small vessels, histologically characterized by inflammation and deposition of both nuclear debris and fibrin in dermal postcapillary venules. The clinical picture typically involves palpable purpura of the lower legs and may be associated with general symptoms such as fatigue, arthralgia and fever. Involvement of the internal organs, most notably the kidneys, the central nervous system or the eyes, is possible and determines the prognosis. Oxaliplatin-induced leukocytoclastic vasculitis is a very rare event that limits treatment options in affected patients. We report 2 patients who developed the condition under chemotherapy for advanced rectal and metastatic colon carcinoma, respectively; a termination of the therapy was therefore necessary. While current therapies for colorectal cancer include the combination of multimodal treatment with new and targeted agents, rare and unusual side effects elicited by established agents also need to be taken into account for the clinical management.
Department of General and Visceral Surgery, University Medical Center, Göttingen, Germany.
Henriette
H
Quack
Department of Dermatology, Venereology and Allergology, University Medical Center, Göttingen, Germany ; Immune Disease Institute, Harvard Medical School/Children's Hospital, Boston, Mass., USA.
Luise
L
Erpenbeck
Department of Radiooncology, University Medical Center, Göttingen, Germany.
Hendrik A
HA
Wolff
Department of General and Visceral Surgery, University Medical Center, Göttingen, Germany.
Thilo
T
Sprenger
Department of Dermatology, Venereology and Allergology, University Medical Center, Göttingen, Germany.
Cornelia S
CS
Seitz
Department of Dermatology, Venereology and Allergology, University Medical Center, Göttingen, Germany.
Michael P
MP
Schön
Department of Haematology and Oncology, Klinikum Wolfsburg, Wolfsburg, Germany.
Steffen
S
Neumann
Department of General and Visceral Surgery, University Medical Center, Göttingen, Germany.
Kathrin
K
Stanek
Department of General and Visceral Surgery, University Medical Center, Göttingen, Germany.
B Michael
BM
Ghadimi
Department of General and Visceral Surgery, University Medical Center, Göttingen, Germany.
Beate
B
Michels
Institute for Pathology, University Medical Center, Göttingen, Germany.
Peter
P
Middel
Institute for Pathology, University Medical Center, Göttingen, Germany.
Inga-Marie
IM
Schaefer
Department of General and Visceral Surgery, University Medical Center, Göttingen, Germany.
Torsten
T
Liersch
Department of General and Visceral Surgery, University Medical Center, Göttingen, Germany.
Lena-Christin
LC
Conradi
Chemotherapy-associated toxicity; Colorectal cancer; Glomerulonephritis; Leukocytoclastic vasculitis; Oxaliplatin