CLINICAL VIGNETTE Vasculitis Mimicry in Patient with Recurrent Cellulitis, Nephrotic Syndrome and Elevated ESR

The patient is a 77-year-old female with past medical history of heavy tobacco use, hypertension, hyperlipi-demia, cerebrovascular accident without residual, chronic renal insufficiency with nephrotic range proteinuria and resistant lower extremity cellulitis who was readmitted to the hospital for worsening pain and erythema of the lower extremities. This was the patient's sixth hospitalization for cellulitis. The patient has been dealing with chronic swelling, redness, and pain in her lower extremities for about a year and a half. She had a stroke in November 2006 followed by seizure with a fall and fracture of her left femur in 3 places requiring repair with titanium rod. Following these events, the patient reported the occurrence of the swelling in the lower extremities i