CASE REPORTS   

Gazzetta Medica Italiana-Archivio per le Scienze Mediche 2009 June;168(3):197-202

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Leucocytoclastic vasculitis in patient with high IgE levels

Parlato A., Vangieri B., Salernitano M., Bresciani M., Gattoni A.

Department of Clinical and Experimental Medicine “F. Magrassi”, Second University of Naples School of Medicine, Naples, Italy

The authors report a case of vasculitis with clinical manifestations of wide necrotic ulcers on the skin of the patient’s inferior limbs and feet associated to high serum total IgE levels. Skin biopsy showed typical histological changes of leukocytoklastic vasculitis. No recovery resulted from treatment with steroids and immunosuppressants. Ulcer healing and recovery was obtained with INF-a, which also determined a decrease in the patient’s serum IgE levels. Our results suggest that immunologic mechanisms caused the ulcers, and that infection and Th2-driven inflammation produced a local decrease in INF-g. INF-a stimulated INF-g production resulting in the healing of the ulcers. We therefore believe that a primary or secondary INF-g deficit can lead to a higher infection sensibility.