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" A case of probable trimethoprim-sulfamethoxazole induced circulating antineutrophil cytoplasmic antibody-positive small vessel vasculitis "
Woodring, Therese; Abraham, Ronnie; Frisch, Stephanie
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AL
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| Record Number
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924299
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LA3j9537pg
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| Language of Document
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English
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| Main Entry
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Woodring, Therese; Abraham, Ronnie; Frisch, Stephanie
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| Title & Author
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A case of probable trimethoprim-sulfamethoxazole induced circulating antineutrophil cytoplasmic antibody-positive small vessel vasculitis [Article]\ Woodring, Therese; Abraham, Ronnie; Frisch, Stephanie
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| Title of Periodical
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Dermatology Online Journal
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| Volume/ Issue Number
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23/8
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| Date
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2017
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| Abstract
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Cutaneous leukocytoclastic vasculitis (LCV) can occur as skin-limited disease or as part a systemic vasculitis. Appropriate workup includes the evaluation of antineutrophil cytoplasmic antibodies (ANCAs), with a positive titer raising concern for the associated primary vasculitides including microscopic polyangiitis (MPA), granulomatosis with polyangiitis (GPA), or eosinophilic granulomatosis with polyangiitis (EGPA). In the absence of systemic findings, however, a drug etiology must also be considered. Tumor necrosis factor (TNF) inhibitors, propylthiouracil, levamisole-adulterated cocaine, hydralazine, and minocycline have been previously documented to induce ANCA-positive vasculitis (APV), which may present with conspicuously high ANCA titers. Herein we report trimethoprim-sulfamethoxazole as another culprit in drug-induced APV. Our case reinforces the need to consider drug etiology for APV and cautions against interpreting positive ANCAs as equivalent to evidence of systemic disease.
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