Home            Past Issues            About IP            About IAP           Author Information            Subscription            Advertisement              Search  

   
images

Indian Pediatr 2016;53: 847

Leukocytoclastic Vasculitis after Exercise

 

*Tania Caroline Monteiro de Castro and Simone de Andrade Lotufo

Medical Doctor, Pediatric Rheumatology, Hospital Infantil Menino Jesus.
Email: [email protected]
 

 


An 11-year-old boy presented with a history of painful red-purple papules on his legs that started at six years of age. The lesions appeared after physical activity, and disappeared within a few days of rest (Fig. 1). Biopsy demonstrated leukocytoclastic vasculitis (papillary dermis, superficial vascular plexus and superficial reticular dermis had blood vessels surrounded by large number of neutrophils and extravasated erythrocytes. The vascular wall was infiltrated with a deposit of eosinophilic material). Direct immunofluorescence was not performed.

Fig. 1 Purpuric plaques on the lower extremities during an exercise-induced flare.

Exercise-induced vasculitis (EIV) may be considered an acute microcirculatory deficiency and thermoregu-lation decompensation with erythrocyte extravasation that occurs after episodes of prolonged muscular activity. Henoch-Schönlein purpura (HSP) is typically the first diagnosis that pediatricians make for patients whose histopathology is leukocytoclastic vasculitis. The onset of symptoms after physical activity and the histopathology findings make the diagnosis of EIV as most likely. No treatment is required as EIV fades spontaneously.

 

Copyright © 1999-2016 Indian Pediatrics