Rapid deterioration of the patient\u2019s condition afteradmission led to the diagnosis of myxedema coma. LT3 administration should be considered as an alternative treatment for myxedema coma patients requiring concomitant glucocorticoid administration. Beyond this, we cannot ignore the established phenomenon of overlapping syndromes of systemic and organ-specific autoimmune diseases. Among others, Biro et al., in a population of 1517 patients with various autoimmune diseases, found that the prevalence of Hashimoto\u2019s thyroiditis or Grave\u2019s disease was 8.2% 6.<\/p>\n
Direct immunofluorescence (DIF) antibody localization demonstrated negative immunoreactivity for immunoglobulins IgG, IgA, IgM, and complement C3 on sections of frozen skin. UV was suspected, and the diagnosis was confirmed when treatment with 0.6 mg twice daily dosing of colchicine resulted in a good clinical response and subsequent remission of his rash. We described the first case of myxedema coma triggered by IgA vasculitis.<\/p>\n
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. The datasets used and\/or analysed during the current study are available from the corresponding author on reasonable request.<\/p>\n
She was diagnosed with coexisting immunoglobulin A (IgA) vasculitis and severe IgA vasculitis with nephritis and was consequently treated with intravenous methylprednisolone (125 mg\/day). However, she rapidly developed multiple organ failure due to the exacerbation of severe hypothyroidism, i.e., myxedema. Her condition improved significantly following oral administration of prednisolone along with thyroxine. There was a delayed increase in the serum free triiodothyronine level, while the serum free thyroxine level was quickly restored to normal. Rapid deterioration of the patient\u2019s condition after admission led us to diagnose her as having myxedema coma triggered by IgA vasculitis.<\/p>\n
The rash consisted of fixed, non-migratory clusters of wheals and pink papules with hyperpigmented macules along the lower back and lower extremities (Figure 1A). Symptom onset typically occurred one month after starting any thyroid replacement medication but would resolve within two months of medication cessation and the addition of systemic corticosteroids. Kidney survival curve of AAV patients with renal injury in different groups. HI, KF, KA, SH, AN, TS, KM, MK, SY, SI, NH, SH, TA, and MN interpreted the data and provided input in the preparation of the manuscript. Figure1 Images of the lower legs, chest X-ray, chest computed tomography, electrocardiogram, and echocardiogram. (C) No abnormalities were found on the electrocardiogram at the time of admission.<\/p>\n
4, 5 However, the causal relationship between Henoch\u2013Sch\u00f6nlein purpura (IgA vasculitis) and Grave’s disease or antithyroid drugs has been remained unclear yet 6. The studies involving human participants were reviewed and approved by Shimada Hospital. The patients\/participants provided their written informed consent to participate in this study. Written informed consent was obtained from the individual(s) for the publication of any potentially identifiable images or data included in this article. Myxedema coma is an endocrine emergency and fatal disease that is rarely encountered (1). Annually, 1.08 cases per million people in Japan and 0.22 cases per million people in Spain develop myxedema coma (2, 3).<\/p>\n
Patients were followed up from the index date until their date of death or March 2022, whichever came first. Information regarding disease progression to the stage of maintenance dialysis or death was collected through telephone inquiries. The authors would like to thank all medical staffs who worked with us at Shimada Hospital for medical supporting and Enago () for the English language review. The original contributions presented in the study are included in the article\/Supplementary Material. This section collects any data citations, data availability statements, or supplementary materials included in this article. Written informed consent was obtained from the patient(s) to publish this paper.<\/p>\n
A Kolmogorov\u2013Smirnov test and P-P diagram were used for the normality test of the included data. Quantitative parameters were assessed with the t-test between groups for normally distributed data, and non-normally distributed data were assessed with the Mann\u2013Whitney U test. Categorical data were compared using the chi-square test or Fisher\u2019s exact test.<\/p>\n
Urticarial vasculitis (UV) is identified as a clinicopathologic entity that involves clinical features of urticaria and histopathologic findings compatible with a cutaneous leukocytoclastic vasculitis of small vessels with fibrinoid deposits. UV represents a spectrum of diseases that differ in severity, ranging from an urticaria with minimal vasculitis to a systemic disease that can lead to serious organ-specific complications. Certainly, urticarial vasculitis is an underdiagnosed disease, to the extent that its incidence may vary from 3 to 20% 1. This is due to the lack of a consensus in medical literature upon a disease that manifests diversely, with a definite diagnosis that relies on a high-tech procedure such as biopsy.<\/p>\n
Disruption of the compensatory mechanism for severe and long-term hypothyroidism by various causes leads to critical conditions, including hypothermia, respiratory failure, circulatory failure, and central nervous system dysfunction. Infectious diseases, stroke, myocardial infarction, sedative drugs, and cold exposure are considered the main triggers for myxedema coma. synthroid scale<\/a> A 59-year-old Japanese woman presented with bilateral painful purpura on her lower legs.<\/p>\n","protected":false},"excerpt":{"rendered":" Drug-induced vasculitis: a clinical and pathological review Rapid deterioration of the patient\u2019s condition afteradmission led to the diagnosis of myxedema coma. LT3 administration should be considered as an alternative treatment for myxedema coma patients requiring concomitant glucocorticoid administration. Beyond this, we cannot ignore the established phenomenon of overlapping syndromes of systemic and organ-specific autoimmune diseases. Among […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[60],"tags":[],"_links":{"self":[{"href":"https:\/\/epecotge.com\/index.php?rest_route=\/wp\/v2\/posts\/10776"}],"collection":[{"href":"https:\/\/epecotge.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/epecotge.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/epecotge.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/epecotge.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=10776"}],"version-history":[{"count":1,"href":"https:\/\/epecotge.com\/index.php?rest_route=\/wp\/v2\/posts\/10776\/revisions"}],"predecessor-version":[{"id":10777,"href":"https:\/\/epecotge.com\/index.php?rest_route=\/wp\/v2\/posts\/10776\/revisions\/10777"}],"wp:attachment":[{"href":"https:\/\/epecotge.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=10776"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/epecotge.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=10776"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/epecotge.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=10776"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}