Sertraline-Induced Leukocytoclastic Vasculitis with Definite Causal Association: A Case Report

Abstract

Antidepressants like sertraline are frequently used to treat psychiatric diseases like depression, panic disorder, and obsessive-compulsive disorder. Small-vessel vasculitis called leukocytoclastic vasculitis is defined histopathologically by immune complex-mediated vasculitis of the dermal capillaries and venules. Typically, it shows up as purpura on the lower extremities, either with or without systemic involvement. Leukocytoclastic vasculitis can be idiopathic but it can also happen in conjunction with several medications. Here, we present data on sertraline-induced leukocytoclastic vasculitis in a patient with major depressive disorder. To our knowledge, sertraline and other selective serotonin reuptake inhibitors have not previously been definitively linked to leukocytoclastic vasculitis, which is rare with antidepressants.

Figure 1.

Palpable non-blanching purpura on both hands.

Figure 2.

Palpable non-blanching purpura on feet.

Figure 3.

Hematoxylin and eosin staining (×400): in the dermis, inflammation rich in eosinophils and neutrophils is observed around the vessel and nerve sheath, and the presence of inflammatory cells in the vessel wall and erythrocyte extravasation in the adjacent dermis is observed.