Leukocytoclastic vasculitis with purpura and renal failure induced by the anti-epidermal growth factor receptor antibody panitumumab: a case report

J Med Case Rep. 2019 Jan 16;13(1):13. doi: 10.1186/s13256-018-1877-7.


Background: Panitumumab is the first human combinatorial antibody for the treatment of metastatic colorectal carcinoma. Dermatologic toxicity of all grades occurs in more than 90% of patients. However, there are few reports of purpura induced by anti-epidermal growth factor receptor antibody. Renal failure is also uncommon as an adverse event of anti-epidermal growth factor receptor antibody.

Case presentation: A 67-year-old Japanese man with advanced colon cancer received monotherapy with panitumumab. General malaise, bilateral edema of his legs, and bilateral purpura of his forearms developed 2 days after the second cycle of panitumumab. A skin biopsy was performed to evaluate the purpuric lesions on his left leg and leukocytoclastic vasculitis was diagnosed. Blood tests showed grade III acute renal failure with a blood urea nitrogen level of 33.8 mg/dL and a creatinine level of 3.10 mg/dL.

Conclusions: This is the first reported case of leukocytoclastic vasculitis followed by purpura and acute renal failure associated with panitumumab.

Keywords: Anti-EGFR antibody; Colon cancer; Leukocytoclastic vasculitis; Panitumumab; Purpura; Renal toxicity.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / chemically induced
  • Acute Kidney Injury / pathology*
  • Aged
  • Colonic Neoplasms / drug therapy*
  • Colonic Neoplasms / pathology
  • Disease Progression
  • Fatal Outcome
  • Humans
  • Leg / pathology*
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / secondary
  • Male
  • Panitumumab / adverse effects
  • Panitumumab / therapeutic use*
  • Purpura / chemically induced
  • Purpura / pathology*
  • Vasculitis, Leukocytoclastic, Cutaneous / chemically induced
  • Vasculitis, Leukocytoclastic, Cutaneous / pathology*


  • Panitumumab