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Case Reports
. 2022 Aug 3;4(15):967-971.
doi: 10.1016/j.jaccas.2022.05.008.

Small-Vessel Vasculitis After ST-Segment Elevation Myocardial Infarction: Clopidogrel or Amiodarone?

Saskia Lehr  1 , Frank Meiss  1 , Dimitra Kiritsi  1 , Leonidas Tsakiris  2   3
Affiliations
Case Reports

Small-Vessel Vasculitis After ST-Segment Elevation Myocardial Infarction: Clopidogrel or Amiodarone?

Saskia Lehr et al. JACC Case Rep. .

Abstract

We report a case of cutaneous small-vessel vasculitis in a patient treated with clopidogrel after an ST-segment elevation myocardial infarction and with amiodarone caused by persistent atrial fibrillation 6 weeks before. (Level of Difficulty: Intermediate.).

Keywords: CSVV, cutaneous small-vessel vasculitis; STEMI, ST-segment elevation myocardial infarction; kidney involvement; leukocytoclastic vasculitis; palpable purpura.

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Conflict of interest statement

Drs Lehr and Kiritsi are funded by the Deutsche Forschungsgemeinschaft (DFG; German Research Foundation), CRC1160/2-B03, Medical Center, University of Freiburg and Faculty of Medicine, University of Freiburg. In addition, this work was supported by the Berta-Ottenstein Advanced Clinician Scientist Programme of the University of Freiburg to Dr Kiritsi and by the German Research Foundation (DFG) through KI1795/2-1 and the CRC-1479, project identifier 441891347 to Dr Kiritsi. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Clinical Pictures of the Patient’s Legs The patient presented with symmetrically distributed palpable purpuric papules on the legs as indicated by white arrows on the (A) left thigh and (B) lower legs.
Figure 2
Figure 2
Electrocardiography of the Patient Showing Inferolateral ST-Segment Elevation
Figure 3
Figure 3
Hematoxylin-Eosin–Stained Histopathologic Sample of a Skin Biopsy Specimen From the Left Thigh Histology revealed characteristic histologic signs of early leukocytoclastic vasculitis (black arrows), consisting of thickening of vessel walls, perivascular neutrophils and lymphocytes, perivascular nuclear dust, and extravasation of erythrocytes. (A) Original magnification ×50 and (B) original magnification ×400.
See this image and copyright information in PMC

References

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