• Kenichi Kishimoto, Kousaku Kawashima, Mai Fukunaga, Satoshi Kotani, Hiroki Sonoyama, Akihiko Oka, Yoshiyuki Mishima, Naoki Oshima, Norihisa Ishimura, Noriyoshi Ishikawa, Riruke Maruyama, and Shunji Ishihara.
• Department of Internal Medicine II, Shimane University Faculty of Medicine, Japan.
• Intern. Med. 2021 Feb 1; 60 (3): 385-389.

AbstractAnti-tumor necrosis factor (TNF) α agents, widely used for the treatment of Crohn's disease (CD), can sometimes induce skin-associated adverse events, which mainly include psoriasis-like eruptions, eczema, and cutaneous infections. In contrast, purpura caused by vasculitis is rarely seen. We herein report a unique case of leukocytoclastic vasculitis induced by infliximab administered for CD in which intermittent purpura development was noted. Fluorescent immunostaining showed no immunoglobulin A deposition on the vessel walls. No purpura was initially seen after starting infliximab, but it appeared approximately 10 months later; however, administration did not have to be discontinued, and the condition was later resolved. The present findings provide important details regarding vasculitis induced by anti-tumor necrosis factor-α agent administration.

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