Vancomycin- Induced Leukocytoclastic Vasculitis in a Patient With End-Stage Renal Disease: A Case Report and Literature Review Publisher Pubmed



Fakhri B MS¹ ; Roostaei G² ; Aghayani S³ ; Shojamoradi MH⁴ ; Vesali B⁵ ; Khoshnam Rad N⁶ Show Affiliations
Source: DARU, Journal of Pharmaceutical Sciences Published:2025

Abstract

Introduction: Leukocytoclastic vasculitis (LCV) is a small-vessel inflammatory condition that can rarely occur as an adverse drug reaction (ADR). Vancomycin-induced LCV is an uncommon but potentially serious complication, particularly in patients with pre-existing renal impairment. Reason for the Report: This case report describes a patient with end-stage renal disease (ESRD) who developed LCV following vancomycin therapy for a catheter-related infection. The report emphasizes the diagnostic challenges and the importance of prompt and appropriate management of this ADR. Case summary: A 53-year-old male with ESRD developed skin lesions and systemic symptoms after receiving vancomycin for catheter-related infection. The diagnosis of LCV was confirmed through a skin biopsy. Discontinuation of vancomycin with initiation of mycophenolate mofetil and prednisolone resulted in significant improvement in the patient’s condition. Outcome: The presented case underlines the recognition of vancomycin-induced LCV, especially in the vulnerable population of patients with ESRD. It emphasizes the need for a high degree of suspicion of drug-related adverse events and early diagnosis and management to achieve good outcomes. Clinical trial number: Not applicable. © The Author(s), under exclusive licence to Tehran University of Medical Sciences 2025.