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Dr. Andrew Rynne

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Suggest treatment for cold, sore throat and nosebleed in a person with leukocytoclastic vasculitis

Answered by
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Dr. Suresh Heijebu

General & Family Physician

Practicing since :2010

Answered : 3580 Questions

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Posted on Wed, 28 Oct 2015 in Ear, Nose and Throat Problems
Question: Hello Doctor, I am a 00 yr old male and had been diagnosed with Leukocytoclastic vasculitis. I was under treatment for about a year and had been doing well. But few days back I had a cold and harsh throat and today while sneezing a lot of blood along with the mucus came. The bleeding hasn't stopped since morning n whenever I sneeze blood comes out (only from the left nostril). Please help.
doctor
Answered by Dr. Suresh Heijebu 3 hours later
Brief Answer:
Possible LCV induced epistaxis?

Detailed Answer:
Hello, Sir.

I understand your concern.

This could be a form of epistaxis-nasal bleed.

This is a possible manifestation of LCV.

It is important that you get few baseline tests like Hb%, HCT, and ESR.

It is important to go for Nasal Packing at the earliest to prevent further bleeding.

Your current medications need to be titrated upwards for this issue if needed.

Post your further queries if any.
Thank you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Suresh Heijebu 7 hours later
Dear Doctor,

Thank you.

I had done the CBC and few other tests last month (refer attached docs.)

Request you to run thru the test report. Also, I'll get it done again.

-- XXXXXXX
doctor
Answered by Dr. Suresh Heijebu 9 hours later
Brief Answer:
Provide further info

Detailed Answer:
Hello, Sir.

I have gone through your uploaded reports as well.

You seem to abnormalities in FBS, ESR, Vitamin D levels.

Vitamin D deficiency needs correction with oral Vit D tablets.

Elevated ESR and FBS could be related to disease activity of LCV.

Further, I would like to know if LCV in your case is idiopathic/sporadic or associated with any specific systemic cause?

This differentiation warrants specific treatments.

Had Any specific autoimmune tests done?

Thank you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Suresh Heijebu 2 days later
Dear Doctor,

Prior to my treatment (a year back) I was having raised skin bumps (reddish coloured). A biopsy was done and it confirmed the LCV. Also there was a vitreous hemorrhage in the right eye. I had to go thru a laser treatment to stop the bleeding. It had happened twice. The doctor described the LCV to be idiopathic. Few medicines were recommended and I had followed it religiously. Everything was fine and I was feeling much better. The treatment seemed to have worked and there were no fresh episodes of raised skin bumps or vitreous hemorrhage or nose bleeds during cold. But the recent cold led to the nose bleeds and this bleeding seems to be similar to the previous episodes of last year - prior to the treatment. Apart from the biopsy no other autoimmune tests were done. Other than CBC + ESR, please recommend few blood tests and I will get it done accordingly. Also, for Vitamin D deficiency I'm taking Calcirol.

--
Regards, XXXXXXX
doctor
Answered by Dr. Suresh Heijebu 20 hours later
Brief Answer:
Relevant tests are suggested.

Detailed Answer:
Hello, Sir.

I apologize for the delayed response.

I can understand your concern.

For any case of LCV, the following tests (EXCLUDING CBC and ESR)are recommended for an effective approach.

1.Complete autoimmune screen.
2.Complete Urine analysis.
3.Serum Electrolytes.
4.RF antibody.
5.Serum protein electrophoresis.
6.HbS Ag.
7.HCV ab.

The last 3 are very important especially in the setting of Idiopathic LCV.

Update me test results.

Post your further queries if any.
Thank you

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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