Hypersensitivity vasculitis (or hypersensitivity angiitis or leukocytoclastic vasculitis) is usually due to a hypersensitivity reaction to a known drug, auto-antigens or infectious agents such as bacteria. Immune complexes lodge in the vessel wall, attracting polymorphonuclear leukocytes who in turn release tissue-degrading substances leading to an inflammatory process. The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... // M00-M99 - Diseases of the musculoskeletal system and connective tissue (M00-M25) Arthropathies (M00-M03) Infectious arthropathies (M00) Pyogenic arthritis (M01) Direct infections of joint in infectious and parasitic diseases classified elsewhere (M02) Reactive arthropathies (M023) Reiters disease (M03) Postinfective and reactive arthropathies in diseases classified elsewhere (M05-M14... The International Statistical Classification of Diseases and Related Health Problems (commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following is a list of codes for International Statistical Classification of Diseases and Related Health Problems. ... The Diseases Database is a free website that provides information about the relationships between medical conditions, symptoms, and medications. ... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ...

Clinical Presentation

Palpable, normally painful, petechiae or purpura (skin vasculitis). The lesions normally arise in crops, with common localizations being the forearms and legs. Necrosis of skin tissue can yield lesions with black or brown centres. This disorder may affect the skin only, but sometimes affect nerves, the kidneys, joints and the heart. Renal involvement is common.

Investigations

The primary goal is to identifiy the causing agent, be it a drug or a microbe. Questioning is important, as is a thorough physical examination, chest X-ray, ESR and biochemical organ tests. Skin biopsy of the lesions reveal inflammation of the small vessels, termed leukocytoclastic vasculitis, which is most prominent in postcapillary venules. Tests for hepatitis virus, antinuclear antibodies, rheumatoid factor and cryoglobins might be indicated.

Diagnostic Criteria

At least 3 out of 5 criteria yields a sensitivity of 71% and a specificity of 84%:

• Age > 16.
• Use of possible triggering drug in relation to symptoms.
• Palpable painful purpura (the three P's).
• Maculopapular rash.
• Skin biopsy showing neutrophil infiltration around vessel.

Treatment

The most important part of the treatment is to eliminate the cause of the vasculitis, if at all possible. Antihistamines prove helpful to some patients. If the vasculitis is damaging organ systems such as the kidneys, immunosuppressive agents are indicated.

See also

• Vasculitis
• Goodpasture's syndrome
• Henoch-Schönlein purpura

In medicine, vasculitis (plural: vasculitides) is a group of diseases featuring inflammation of the wall of blood vessels due to leukocyte migration and resultant damage. ... Goodpasture’s syndrome (also known as Goodpasture’s disease and anti-glomerular basement membrane disease or anti-GBM disease) was first described by Ernest Goodpasture in 1919. ... In medicine (rheumatology and pediatrics) Henoch-Schönlein purpura (HSP, also known as allergic purpura) is a systemic vasculitis characterized by prominent tissue deposition of IgA-containing immune complexes, especially in the skin and kidney. ...

External links

• GPnotebook -1449525237