Bortezomib induced Henoch-Schönlein purpura during a succesful treatment of multiple myeloma (case report)

Abstract

Abstract BACKGROUND. Bortezomib is a well-known frontline therapy for newly-diagnosed multiple myeloma (MM). There have been several case reports about skin vasculitis as a rare side effect of this medicine and one case report about intestinal vasculitis. We are now demonstrating 1st case of a vasculitis affecting skin, intestine and kidney in a single patient. CASE PRESENTATION. Our patient is a 77-year-old woman with MM treated with bortezomib, melphalan and prednisone. She developed leukocytoclastic vasculitis of legs, bloody diarrhea and nephrotic proteinuria. Since the hematological response had been achieved, her condition was understood as a side effect of bortezomib and was completely resolved by discontinuation of the drug and administration of corticosteroids. CONCLUSIONS. These three simultaneous signs suggest a common pathophysiology of the vasculitis manifesting on skin, intestine and kidney also known as Henoch-Schönlein purpura (HSP) and to the best our knowledge is 1st report of this combination of side effects of bortezomib therapy. Clinicians should be aware of this rare, yet possible side effect when treating patients with bortezomib so they could timely recognise it and treat it.