Abstract
Some infectious, rheumatic, allergic diseases, and malignancies have been associated with leucocytoclastic vasculitis (LCV). LCV and cancer occur most frequently in patients with hematological malignancies such as lymphomas and leukemias. There have been a few prior cases reported of LCV associated with renal cell carcinoma (RCC). A 25-year-old male patient was referred from the department of dermatology and nephrology because of recurrent petechiae on both lower legs for several months; the patient also had a tumor of the left kidney. The findings on the skin biopsy were compatible with the diagnosis of LCV. The patient was diagnosed as having Henoch–Schönlein purpura (HSP) with LCV. A CT scan performed due to abdominal pain revealed a mass on the upper pole of the left kidney. A partial nephrectomy of the left kidney including the tumor was performed. The pathology report was consistent with a clear cell type of renal cell carcinoma, Fuhrman’s grade 2; the tumor measured 0.9 × 0.8 cm and focal segmental glomerulosclerosis was noted in non-neoplastic regions. Here, we report a case of LCV associated with RCC presenting as HSP. This case illustrates the importance of evaluating patients for an underlying malignancy when HSP or LCV is diagnosed.
References
Çurgunlu A, Karter Y, Uyaník Ö, Yunçkale A, Çurgunlu S (2004) Leukocytoclastic vasculitis and renal cell carcinoma. Intern Med J 43:256–257
Fain O et al (2007) Vasculitides associated with malignancies: analysis of sixty patients. Arthritis Rheum 57:1473–1480
Palapattu GS, Blaine K, Rajfer J (2002) Paraneoplastic syndromes in urologic malignancy: the many faces of renal cell carcinoma. Rev Urol 4(4):163–170
Hunger RE, Dürr C, Brand CU (2001) Cutaneous leukocytoclastic vasculitis in dermatomyositis suggests malignancy. Dermatology 202:123–126
Naschitz JE, Yeshurun D, Eldar S, Lev LM (1996) Diagnosis of cancer-associated vascular disorder. Cancer 77:1759–1767
Bunn PA Jr (1982) Paraneoplastic syndromes. In: DeVita VT Jr, Hellman S, Rosenberg SA (eds) Cancer: principles and practice of oncology. Lippincott, Philadelphia, pp 1476–1517
Kurzrock R, Cohen PR, Markowitz A (1994) Clinical manifestations of vasculitis in patients with solid tumors. Arch Intern Med 154:334–340
Motzer RJ, Bander NH, Nanus DM (1996) Medical progress: renal cell carcinoma. N Engl J Med 335:865–875
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hong, Y.H. Renal cell carcinoma presenting as Henoch–Schönlein purpura with leukocytoclastic vasculitis, hematuria, proteinuria and abdominal pain. Rheumatol Int 30, 1373–1376 (2010). https://doi.org/10.1007/s00296-009-1063-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-009-1063-8