A Spotlight on Drug-Induced Vasculitis

Abstract

Purpose of review: Drug-induced vasculitis (DIV) is a rare form of vasculitis related to the use of various drugs. DIV primarily affects small to medium size vessels, but it can potentially involve vessels of any size. Differentiating between primary systemic vasculitis and DIV can be challenging; however, it is crucial, so that the offending agent can be discontinued promptly.

Recent findings: The clinical phenotype of DIV is protean and depends on the size of the affected vessels. It ranges from arthralgias, to an isolated cutaneous rash, to severe single or multi-organ involvement. While withdrawal of the offending drug is the most important step in management, a significant number of patients require immunosuppressive therapy for varying periods of time. DIV can affect any vascular bed size, leading to protean vasculitic syndromes. Increased awareness among general practitioners, specialty, and subspecialty physicians is crucial for early recognition, and withdrawal of drug for better outcomes.

Keywords: Cocaine; Drug-induced ANCA-associated vasculitis; Drug-induced vasculitis (DIV); Granulocyte colony-stimulating factor (G-CSF); Hydralazine; Immune checkpoint inhibitors (ICIs); Minocycline; Propylthiouracil; Tumor necrosis factor-α (TNF-α).