Wegener’s granulomatosis is an organ- and/or life-threatening autoimmune disease of as yet unknown etiology. The classic clinical triad consists of necrotizing granulomatous inflammation of the upper and/or lower respiratory tract, necrotizing glomerulonephritis, and an autoimmune necrotizing systemic vasculitis affecting predominantly small vessels.
The detection of antineutrophil cytoplasmic antibodies directed against proteinase 3 (PR3-ANCA) is highly specific for Wegener’s granulomatosis. ANCA positivity is found only in about 50% of the patients with localized Wegener’s granulomatosis (which is restricted to the respiratory tract and affects< or = 5% of the patients), whereas PR3-ANCA positivity is seen in 95% of the patients with generalized Wegener's granulomatosis
Adverse Effects of Hormonal contraception
- Cardiovascular Effects
- - Myocardial Infarction
- - Stroke
- - Arterial Accidents
- - Venous Thromboembolism
- - Blood Hypertension
- Other Effects
- - Angioedema
- - Peliosis Hepatis
- - Severe Adverse Ocular Reactions
- - Vasculitis
- Moderate adverse effects
- Cancer Risks
- - Breast cancer risk
- - Ovarian cancer risk
- - Endometrial cancer risk
- - Cervical cancer risk
- - Colorectal cancer risk
- - Skin cancer risk
- - Liver cancer risk
- - Pancreatic cancer risk
- - Neurofibromas growth
- - Unclear cancer risks
- Hazardous prescription
- Hormonal contraception in female transplant recipients
- - Hormonal contraception in female kidney recipients
- - Hormonal contraception in female liver transplant recipients
- - Hormonal contraception in female heart transplant recipients
- - Contraception in women HIV infected
- Mild Adverse effects
- New Perspectives immunocontraception
- Contraceptive counseling
Vasculitis is an independent risk factor for diffuse endothelial dysfunction and may be a consequence of TNF-alpha action on endothelial cells (9,10).
Polyarteritis nodosa has been progressive illness resulting in a systemic necrotizing vasculitis which may affect the kidneys, gastrointestinal tract, skin, nerves and muscles. Churg-Strauss is a hypereosinophilic syndrome inducing systemic vasculitis (10). The subjects affected may be tested for the presence of the FIP1L1-PDGRFA mutation (13).
In conclusion, hormonal contraceptives may induce allergic vascularities. It is hypotesized as possible etiology a reaction of cell-mediated immunity. Affected subjects may present cutaneous involvement alone or life-threatening systemic involvement, which may result in severe and sometimes fatal illness.
Although, oral contraceptives when implicated induce generally mild vasculitis, a rare case of vasculitis with cutaneous necrosis HC- containing levonorgestrel 0.15 μg and ethinylestradiol 0.03 mg related was reported (14).
Rosa Sabatini and Giuseppe Loverro
Dept. Obstetrics and Gynecology,
General Hospital Policlinico-University of Bari, Italy
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