DIGITAL VASCULITIS FOLLOWING ALLERGIC DESENSITIZATION-TREATMENT

Systemic necrotizing vasculitis or a polyarteritis nodosa-like clinica l presentation, is an unusual complication of immunotherapy (hyposensi tization therapy). We describe a patient who developed features of vas culitis several years after beginning hyposensitization treatment for allergic rhinitis. In the 7 months preceding the onset of the vasculit is he experienced 4 episodes of anaphylaxis immediately after receivin g desensitization injections. The vasculitis was characterized by the abrupt onset of pain and discoloration of the middle 3 digits of his r ight hand. Cyanosis and small areas of frank necrosis of these digits were present. Erythrocyte sedimentation rate and C-reactive protein we re elevated and total serum complement was decreased. The development of digital vasculitis following hyposensitization is clearly illustrat ed in this patient.