Al-Busafi Said A, Al-Suleimani Abdulatif, Al-Hamadani Aysha, Rasool Wasif
Department of Medicine, Division of Gastroenterology and Hepatology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.
Internal Medicine Training Program, Oman Medical Specialty Board, Muscat, Oman.
Oman Med J. 2017 Sep;32(5):429-431. doi: 10.5001/omj.2017.80.
Tenofovir, a nucleotide analog, is one of the first-line medications recommended for the treatment of active chronic hepatitis B virus infection (CHB) and as a primary prophylaxis to prevent hepatitis B reactivation in cases of immunosuppression. We report the first case of tenofovir-induced leukocytoclastic vasculitis (LCV). A 43-year-old obese woman, who was known to have inactive CHB, was diagnosed with chronic immune thrombocytopenic purpura (ITP). She was treated with corticosteroid therapy and was put on tenofovir to prevent hepatitis B virus reactivation. A month later, she developed a skin rash, described as non-blanchable well-defined erythematous to violaceous papules and targetoid patches in her lower extremities. A skin biopsy showed features of LCV. The rash resolved completely within few days after replacing tenofovir with entecavir.
替诺福韦是一种核苷酸类似物，是推荐用于治疗活动性慢性乙型肝炎病毒感染（CHB）的一线药物之一，也是在免疫抑制情况下预防乙型肝炎再激活的主要预防药物。我们报告了首例替诺福韦诱发的白细胞破碎性血管炎（LCV）病例。一名43岁的肥胖女性，已知患有非活动性CHB，被诊断为慢性免疫性血小板减少性紫癜（ITP）。她接受了皮质类固醇治疗，并服用替诺福韦以预防乙型肝炎病毒再激活。一个月后，她出现了皮疹，表现为下肢不可压褪色的边界清晰的红斑至紫红色丘疹和靶样斑块。皮肤活检显示有LCV的特征。在用恩替卡韦替换替诺福韦后的几天内，皮疹完全消退。
