Cryoglobulinemic vasculitis resistant to intermittent intravenous pulse cyclophosphamide therapy.
We report on a 78-year-old patient with severe disease manifestations including polyneuropathy and clinically suspected secondary temporal arteritis due to hepatitis C virus-associated cryoglobulinemic vasculitis (CV). Despite intermittent intravenous pulse cyclophosphamide therapy and oral corticosteroid therapy her condition further deteriorated. Only oral cyclophosphamide therapy with high-dose corticosteroid and plasmapheresis was efficient in inducing a remission of her CV. This case report demonstrates that pulse cyclophosphamide therapy may not be sufficient to control severe manifestations of cryoglobulinemic vasculitis.
Lamprecht
P
P
Poliklinik für Rheumatologie, Universitätsklinikum Lübeck, Medizinische Universität zu Lübeck, and Rheumaklinik Bad Bramstedt, Germany.
Gause
A
A
Gross
W L
WL
D000284:Administration, Oral; D000368:Aged; D003449:Cryoglobulinemia / Q000150:complications / Q000188:drug therapy*; D003520:Cyclophosphamide / Q000008:administration & dosage*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007275:Injections, Intravenous; D010956:Plasmapheresis; D011239:Prednisolone / Q000627:therapeutic use; D020551:Pulse Therapy, Drug; D014657:Vasculitis / Q000150:complications / Q000188:drug therapy*
D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D011239:Prednisolone