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In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 2878 - 19 July 2021 Posted By: Dr. Mona Abdel-Halim

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
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M 26,Purpuric rash on both legs .Patient also had elevated kidney function tests


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Richard Logan

Posted

I think there may have been some image manipulation which is obscuring some of the cytological detail.  It is not possible to say whether there is any fibrin deposited around the vessels.

I would vote for small vessel vasculitis (previously known and loved as leukocytoclastic vasculitis), which, in conjunction with kidney malfunction in a younger patient raises the possibility of IgA vasculitis (previously known and loved as Henoch-Schonlein Purpura).

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Yes. Difficult to say if there is any fibrinoid necrosis of the small vessels, but leukocytoclastic detail is conspicuous.  So agree with Richard. 

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Eman El-Nabarawy

Posted

Microscopic polyangiitis.

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Krishnakumar subramanian

Posted

small vessel vasculitis

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Dr. Mona Abdel-Halim

Posted

P-ANCA was positive. This was diagnosed as microscopic polyangiitis.

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Krishnakumar subramanian

Posted

Pathologically, microscopic polyangiitis (MPA) may cause necrotizing arteritis that is histologically identical to that caused by polyarteritis nodosa. Madam can you please suggest. We can make diagnosis of LCV on histology and MPA diagnosis  only based on serology

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