Leukocytoclastic Vasculitis Secondary to Severe Fever with Thrombocytopenia Syndrome

Intern Med. 2023 Oct 6. doi: 10.2169/internalmedicine.2504-23. Online ahead of print.

Abstract

A 75-year-old Japanese woman was admitted to our hospital and diagnosed with hemophagocytic syndrome secondary to severe fever with thrombocytopenia syndrome (SFTS). The patient recovered after steroid treatment and was discharged from the hospital. Two months after the onset of SFTS, the patient revisited our hospital with a fever and palpable purpura on the extremities and trunk. A histopathological examination of a punch skin biopsy specimen revealed leukocytoclastic vasculitis. Symptomatic treatment resolved the fever, and palpable purpura disappeared 14 days later. No other clinical symptoms or abnormal immunological findings contributed to the leukocytoclastic vasculitis. This is the first report to describe leukocytoclastic vasculitis secondary to SFTS, highlighting a potential association between the two conditions.

Keywords: Hemophagocytic syndrome; Leukocytoclastic vasculitis; Purpura; Severe Fever with Thrombocytopenia Syndrome.