Severe leukocytoclastic vasculitis of the skin in a patient with essential mixed cryoglobulinemia treated with high-dose gamma-globulin intravenously.
We describe a patient with long-standing severe leukocytoclastic vasculitis of the skin and essential mixed cryoglobulinemia type II, who showed a limited reaction to immunosuppressive drugs, plasmapheresis, and colchicine. Therapy with high-dose gamma-globulin intravenously (IV) for five days resulted in disappearance of vasculitis lesions within three weeks. After gamma-globulin IV treatment there was a decrease in cryoglobulin, circulating immune complexes, and IgM, paraprotein, and a rise in complement levels. No serious side effects were noted during or after gamma-globulin IV treatment. The patient has been in remission for 16 months.
Boom
B W
BW
Department of Dermatology, University Hospital, Leiden, the Netherlands.
Brand
A
A
Bavinck
J N
JN
Eernisse
J G
JG
Daha
M R
MR
Vermeer
B J
BJ
D000208:Acute Disease; D000328:Adult; D003078:Colchicine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003449:Cryoglobulinemia / Q000473:pathology / Q000628:therapy*; D004359:Drug Therapy, Combination; D006801:Humans; D007116:Immunization, Passive; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007262:Infusions, Intravenous; D008297:Male; D009336:Necrosis; D010956:Plasmapheresis; D012867:Skin / Q000473:pathology; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000473:pathology / Q000628:therapy*; D005719:gamma-Globulins / Q000008:administration & dosage*
D007166:Immunosuppressive Agents; D005719:gamma-Globulins; D003078:Colchicine