Leukocytoclastic vasculitis complicating cisplatin + radiation treatment for laryngeal cancer: a case report

• Published in: BMC cancer Vol. 17; no. 1; p. 831
• Main Authors: Quintanilha, Júlia Coelho França, Visacri, Marília Berlofa, Amaral, Laís Sampaio, Lima, Carmen Silvia Passos, Cintra, Maria Letícia, Moriel, Patricia
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 06.12.2017; BioMed Central; BMC
• Subjects: Antineoplastic agents; Cancer; Case Report; Chemotherapy; Cisplatin; Drug therapy; Drug-related side effects; Health aspects; Leukocytoclastic vasculitis; Oncology; Radiation (Physics); Radiotherapy; Skin; Vasculitis; Leukocytoclastic vasculitis; Drug-related side effects; Oncology; Case report; Chemotherapy; Cisplatin
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-017-3848-6

Leukocytoclastic vasculitis is typically mediated by deposition of immune complexes and is related to many causes, including medication. To the best of our knowledge, leukocytoclastic vasculitis related to cisplatin has not yet been described in the scientific literature. We report a rare case of leukocytoclastic vasculitis after the first cycle of high-dose cisplatin chemotherapy in a patient with larynx carcinoma. A 48-year-old Caucasian man with larynx carcinoma received a high-dose of cisplatin monochemotherapy (100 mg/m every 21 days), along with 70 Gy of radiotherapy divided into 35 sessions, as a therapeutic schedule. Twelve days after the first chemotherapy administration and after 8 sessions of radiotherapy (total of 16 Gy), the patient presented with acute onset of palpable purpura in the lower limbs. The patient was hospitalized for 10 days, and during this period, he underwent several examinations to rule out infectious, autoimmune, and neoplastic disorders. A skin biopsy showed leukocytoclastic vasculitis with a positive pattern for IgM and C3, as detected through direct immunofluorescence. Twenty-five days after cisplatin administration, the chemotherapy regimen was changed to carboplatin AUC 5, and the episodes of purpura ceased, reinforcing the hypothesis of an adverse reaction to cisplatin. Cisplatin can induce leukocytoclastic vasculitis and clinicians should be aware of this potential effect for better case management and diagnosis.