Open AccessLIVEdoid vasculopathy – benefit of intravenous immunoglobulin in a refractory case
Author(s) -
Ştefan Cristian Dinescu,
Andreea Lili Bărbulescu,
Paulina Lucia Ciurea,
Roxana Mihaela Dumitrașcu,
Beatrice Andreea Chisălău,
Cristina Dorina Pârvănescu,
Sineta Cristina Firulescu,
Florentin Ananu Vreju
Publication year - 2021
Publication title -
romanian journal of rheumatology
Language(s) - English
Resource type - Journals
eISSN - 2069-6086
pISSN - 1843-0791
DOI - 10.37897/rjr.2021.1.4
Subject(s) - livedo reticularis , medicine , vasculitis , refractory (planetary science) , dermatology , thrombosis , intravenous immunoglobulins , antiphospholipid syndrome , colchicine , defibrotide , intravenous immunoglobulin therapy , disease , antibody , immunology , pathology , surgery , physics , astrobiology , hematopoietic stem cell transplantation
Livedoid vasculopathy is a rare vascular disease which typically manifests as recurrent ulcerative lesions on the lower extremities. It is classified as a vasculopathy, not a true vasculitis, and defined as a vasooclusive syndrome, caused by non-inflammatory thrombosis of the upper and mid-dermal venulae. Main disorders associated with LV include thrombophilias, autoimmune diseases and neoplasia. A triad of clinical features is present in most patients and consist of livedo racemosa (less frequently livedo reticularis), ulcerations and atrophie blanche. Management generally relies on antiplatelet drugs, anticoagulants, vasodilators and fibrinolytic therapy. Some benefit has been observed with intravenous immunoglobulin, colchicine, hyperbaric oxygen, while glucocorticoids are efficient to a lesser extent. This case report highlights a refractory clinical form with no identifiable predisposing condition, which proved responsive only to intravenous immunoglobulin.