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Abstract
A 26-year-old male patient presented to our rheumatology clinic with pain, swelling and limitation of movement in his right ankle, and also purpuric skin lesions in the lower extremity pretibial region. He was asked questions, and he said that he had been having chronic low back pain and morning stiffness for the last few years. His physical examination revealed that he had arthritis in his right ankle, purpuric skin lesions in pretibial regions of both legs, and bilateral FABERE/FADIR positivity. The sacroiliac joint imaging and MRI revealed bilateral sacroiliitis findings, and the lateral heel imaging revealed enthesitis. HLA-B27 was positive. Skin biopsy from lower skin lesions was reported to be consistent with leukocytoclastic vasculitis. Based on clinical, laboratory, radiological, and pathological examinations, the patient was diagnosed with ankylosing spondylitis and leukocytoclastic vasculitis. Administration of corticosteroid, salazopyrin, and nonsteroid anti-inflammatory medications was started. Notable clinical and laboratory regression was observed during his checks 3 months later.
Highlights
Ankylosing spondylitis (AS) is a chronic inflammatory disease, which can involve the spine and the sacroiliac joint
In the classification by Chapel Hill Consensus Conference in 1994, leukocytoclastic vasculitis was included in the “small vein vasculitis” based on the vein diameter involved [11]
Some authors state that cutaneous leukocytoclastic vasculitis is vasculitis limited to the skin, and some state that systemic involvement can be mild to moderate
Summary
Ankylosing spondylitis (AS) is a chronic inflammatory disease, which can involve the spine and the sacroiliac joint. Leukocytoclastic vasculitis (LV) is a disease characterized by inflammation of small veins [1]. Its etiology includes various causes such as drugs, chemicals, infections, malignancies, lymphoproliferative disorders, connective tissue diseases, and systemic inflammatory diseases [2, 3]. Blanco et al have shown that collagen tissue diseases are the most common causes of etiology of leukocytoclastic vasculitis [9]. The process, which starts when immune complexes activate the complement system, results in the damaging of vein walls by inflammatory cells [10]. Coexistence of ankylosing spondylitis and leukocytoclastic vasculitis is very rare and is limited to only a few case reports. We report a case of AS coexisting with leukocytoclastic vasculitis
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