ISSN: 1308-5727 | E-ISSN: 1308-5735
Volume: 16 Issue: 4 Year: 2024
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Turkish Society for Pediatric Endocrinology and Diabetes
Vasculitis-like Palpable Purpuric Rash Induced by Decapeptyl in a Pediatric Patient Diagnosed Central Precocious Puberty [J Clin Res Pediatr Endocrinol]
J Clin Res Pediatr Endocrinol. 2023; 15(3): 307-311 | DOI: 10.4274/jcrpe.galenos.2021.2021.0205

Vasculitis-like Palpable Purpuric Rash Induced by Decapeptyl in a Pediatric Patient Diagnosed Central Precocious Puberty

Nilüfer Galip1, Nermin Ankay2, Rüveyde Bundak3
1University of Kyrenia, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Allergy and Clinical Immunology, Kyrenia, North Cyprus
2Dr. Burhan Nalbantoğlu State Hospital, Clinic of Pediatrics, Nicosia, North Cyprus
3University of Kyrenia, Faculty of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Kyrenia, North Cyprus

Central precocious puberty (CPP) is defined as the appearance of secondary sexual signs in girls younger than eight years of age or the onset of menarche before the age of 10 years. Gonadotropin-releasing hormone analogs (GnRHa) are the most effective therapy in CPP. Drug-induced hypersensitivity vasculitis is an inflammation of blood vessels, which may be due to the use of a number of pharmacologic agents. This case report describes drug-induced vasculitis in a girl being treated with Decapeptyl. A 7.25 year-old girl was admitted to Pediatric Endocrinology outpatients with premature breast development. She was diagnosed with CPP on the basis of physical examination and laboratory findings and tripoteline acetate (Decapeptyl®) treatment was initiated. She experienced multiple widespread skin rashes and mild abdominal pain with high temperature eight hours after the second dose of Decapeptyl. She was admitted to hospital with the diagnosis of drug-induced vasculitis and a single dose of intravenous methyl-prednisolone (1 mg/kg) and oral cetirizine was given. Her blood and urine analysis revealed no other organ involvement, other than skin. On the third day, the purpuric lesions began to resolve and had completely disappeared by the sixth day. Her treatment for CPP was switched to Depot Leuprolide acetate and she continued her treatment for two years uneventfully. To the best of our knowledge, this is the first report of a child with CPP experiencing drug-induced vasculitis due to tripotelin injection. Effective treatment may be continued by switching to an alternative gonadotropin releasing hormone analog.

Keywords: Drug-induced, central precocious puberty, vasculitis, vasculitis-like rash

Corresponding Author: Nilüfer Galip, Cyprus
Manuscript Language: English
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