FATİH YILDIRIM, ŞEVKET ALİ EKMEN, CEMAL BES
Anatolian Current Medical Journal - 2025;7(4):485-491
Aims: This study aimed to evaluate the clinical and pathological characteristics of adult patients with leukocytoclastic vasculitis (LCV) and to assess the diagnostic impact of direct immunofluorescence (DIF) test in rheumatology practice. Methods: The study included 102 adult patients admitted to the rheumatology clinic with palpable purpura between June 2020 and April 2025. All of the patients have a DIF test and a positive skin biopsy for LCV. The clinical and histopathological characteristics of the patients were retrospectively reviewed. Results: After all diagnostic tests, 84 patients (82.4%) were classified as immunoglobulin A vasculitis (IgAV) and 11 (10.8%) as single-organ cutaneous small vessel vasculitis (SoCSVV). Sixty-five patients (63.7%) had comorbid diseases; endocrine-metabolic (36.3%) and cardiovascular diseases (30.4%) were the most common. Eighty-four patients (82.3%) received corticosteroids at various doses, and 41 (40.1%) received steroid-sparing agent. The DIF test supported the final clinical diagnosis in 55 patients (54%), was negative in 27 patients (26.4%), and revealed non-specific findings in 20 patients (19.6%). DIF results led to a change in the clinical pre-diagnosis in only 14 patients (13.7%). No significant differences were found between the two groups when comparing the laboratory and clinical findings at presentation in patients with skin-limited systemic vasculitis and those with SoCSVV. Conclusion: Leukocytoclastic vasculitides that are assessed in adult rheumatology clinics are highly likely to be part of systemic vasculitides, particularly IgAV. Most adults with LCV have comorbidities and need corticosteroids. In clinical practice, the impact of the DIF test on classifying patients with LCV is limited.
