From membranoproliferative glomerulonephritis to a final diagnosis: Hypocomplementemic urticarial vasculitis syndrome

Membranoproliferative glomerulonephritis describes a glomerular-injury pattern common to a heterogeneous group of diseases. Evaluation based on clinical and laboratory presentation and immunofluorescence staining on kidney biopsy allows identification of underlying pathophysiological processes and may facilitate proper diagnosis and treatment. Hypocomplementemic urticarial vasculitis syndrome is a rare autoimmune disease of multi-organ involvement. The diagnosis is based on well-defined clinical and laboratory criteria. The pathophysiology is not completely understood but the presence of anti-C1q antibody seems to be involved. Renal involvement occurs in up to 50% of cases. It can be heterogeneous and can be indistinguishable from lupus nephritis. Serological findings and skin involvement distinguish these two entities. We report the case of a 40-year-old female who presented with urticarial skin lesions, hypocomplementemia and nephrotic syndrome. Kidney biopsy showed membranoproliferative glomerulonephritis with full house immune complex deposits. The diagnosis of hypocomplementemic urticarial vasculitis syndrome was made and the patient was successfully treated with prednisolone and mycophenolate mofetil.

Chronic spontaneous urticaria or urticarial vasculitis?

Differential diagnosis of chronic spontaneous urticaria (CSU) and urticarial vasculitis (UV) is carried out in the case of an atypical clinical picture of urticaria. Wheals lasting longer than 24 hours, often accompanied by burning and pain, leaving behind purpura or residual hyperpigmentation. This article describes a case of urticarial vasculitis in a patient that required differential diagnosis of CSU and UV several years after the onset of the disease. Successful treatment was carried out with a combination of antihistamines, glucocorticosteroids, hydroxychloroquine and omalizumab.

Dermatological manifestations in COVID-19 positive patients in a tertiary care center at Kanchipuram: an observational study

<p class="abstract"><strong>Background:</strong> Among the other systemic manifestations of COVID-19, cutaneous manifestations are also seen increasingly, but literature about those are significantly less. The skin manifestations in COVID are polymorphic according to studies. The aim of the study was to determine the cutaneous manifestations in COVID-19 positive patients at a tertiary care centre in Kanchipuram.</p><p class="abstract"><strong>Methods:</strong> The ethics committee approved this study in our institution. The study period was 6 months (May 2020-October 2020) and those found to be SARS‐CoV‐2 positive after testing with RT‐PCR test were enrolled.<strong></strong></p><p class="abstract"><strong>Results:</strong> In 200 patients, 20 (10%) patients had dermatological manifestations, of which urticaria was present in 7 patients (35%), pruritus was present in 4 patients (20%), 2 (10%) had urticarial vasculitis, 3 (15%) had miliaria rubra, 2 (10%) had mask induced acne and 2 (10%) had maculopapular rash. The presence of dermatological manifestations did not show any significant association between asymptomatic and symptomatic cases.</p><p class="abstract"><strong>Conclusions:</strong> COVID-19 positive patients asymptomatic or symptomatic with mild to moderate symptoms can have less dermatological manifestations.</p>