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Cutaneous Vasculitis After Renal Transplantation: A Case Report
Authors:S. Rau  A. Wollenberg  M. Weiss  M. Fischereder  U. Schönermarck
Affiliation:1. Department I of Internal Medicine, Nephrology Division, Ludwig Maximilians University, Munich, Germany;2. Department of Dermatology and Allergy, Ludwig Maximilians University, Munich, Germany;3. Department of Pathology, Ludwig Maximilians University, Munich, Germany
Abstract:BackgroundCutaneous vasculitis is a rare symptom after renal transplantation. With a broad spectrum of differential diagnosis, the new appearance of a skin rash in transplanted patients can be challenging.Case ReportWe present the case of a 69-year-old man with palpable purpura, skin ulcerations, and diffuse arthralgias. He had a history of cadaveric renal transplantation owing to biopsy-proven isolated immunoglobulin (Ig)A nephropathy and never suffered from any skin manifestation before. Skin biopsy confirmed Henoch–Schoenlein purpura (HSP), which developed under maintenance immunsuppressive therapy with tacrolimus and mycophenolate mofetil. Renal biopsy showed recurrent IgA nephropathy with positive mesangial and capillary IgA staining.DiscussionThis is the first case to describe a new manifestation of HSP following renal transplantation owing to isolated IgA nephropathy. Here, we summarize the differential diagnosis of cutaneous vasculitis following renal transplantation. Moreover we give a short review of the recurrence of IgA nephropathy and HSP after renal transplantation followed by possible strategies for prevention and therapy of recurrent disease.
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