Lymphocytic vasculitis developing after Hepatitis A vaccine and successful treatment with Nadroparin Calcium

Among the various types of vasculitis, the most common is small vessel vasculitis involving the post capillary venules. Etiological factors are drugs, infectious agents, blood disorders, malignancies and rheumatological disorders. In this report, a Hepatitis B virus (HBV) carrier patient who experienced lymphocytic vasculitis after vaccination for Hepatitis A is presented. On admission, the patient had desquamated red-purple rashes with the dimension of approximately 23cm, scattered on both arms and elbows. The lesions appeared 20 days after the Hepatitis A vaccine. Liver function tests, complete blood count, erythrocyte sedimentation rate, blood urea nitrogen and serum C-reactive protein levels were within normal ranges. Pathology of the skin biopsy taken from the dorsum of hand was consistent with lymphocytic vasculitis. With the subcutaneous Nadroparin calcium (2x0.4ml) treatment, the patient recovered completely in four weeks. In conclusion, physicians should also consider the adverse effect of hepatitis A vaccine in the differential diagnosis of lymphocytic vasculitis.