Cytophagic histiocytic panniculitis improved by combined CHOP and cyclosporin A treatment.
In a 31-year-old Japanese man with cytophagic histiocytic panniculitis (CHP) remission was achieved by a combination of combined chemotherapy CHOP and cyclosporin A treatment. He was admitted to our hospital in January 1994 with recurrent high fever of 40.2 degrees C and tender and violaceous subcutaneous nodules on his trunk, arms and legs. He developed pancytopenia, hemorrhagic diathesis, liver dysfunction. Histological examination of the biopsied subcutaneous nodule revealed a lobular panniculitis with fat necrosis and a massive infiltration of histiocytes phagocytosing nuclear debris. He was treated initially with 40 mg/day prednisolone. However, following a reduction in prednisolone dosage, his symptoms reappeared. CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) therapy was then initiated. Three courses of CHOP treatment alleviated his symptoms and cyclosporin A was used to maintain his condition for 15 months. His medication was then discontinued and he has been in complete remission for 10 months. Combined treatment of cyclosporin A and CHOP combined chemotherapy was shown to be effective for this patient with severe CHP.
Ito
M
M
Department of Internal Medicine II, Fukushima Medical University School of Medicine.
Ohira
H
H
Miyata
M
M
Suzuki
T
T
Sato
Y
Y
Kaise
S
S
Nishimaki
T
T
Sakuma
H
H
Nihei
Y
Y
Iwatsuki
K
K
Kasukawa
R
R
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001706:Biopsy; D003520:Cyclophosphamide / Q000627:therapeutic use; D016572:Cyclosporine / Q000627:therapeutic use*; D004317:Doxorubicin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005218:Fat Necrosis / Q000188:drug therapy / Q000473:pathology; D005500:Follow-Up Studies; D015614:Histiocytosis / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D010201:Panniculitis, Nodular Nonsuppurative / Q000188:drug therapy* / Q000473:pathology; D010587:Phagocytosis; D011241:Prednisone / Q000627:therapeutic use; D012008:Recurrence; D014750:Vincristine / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D014750:Vincristine; D004317:Doxorubicin; D016572:Cyclosporine; D003520:Cyclophosphamide; D011241:Prednisone