title: Cutaneous ulcers with type I cryoglobulinemia treated with plasmapheresis.
abstract: Severe necrotic cutaneous ulcers and kidney involvement secondary to type I cryoglobulinemia can be a therapeutic challenge. Plasmapheresis has been reported useful to treat autoimmune diseases such as thrombotic thrombocytopenic purpura, systemic lupus erythematosus, myasthenia gravis and Goodpasture's syndrome. We report the case of a patient who presented necrotic lesions with kidney involvement due to type I cryoglobulinemia (Ig G kappa) that evolved to a multiple myeloma. Treatment with high doses of corticosteroid plus cyclophosphamide did not control the disorder. Therapy with plasmapheresis produced a marked decrease in cryoglobulin levels and a subsequent relevant clinical improvement of cutaneous lesions and renal function. In cryoglobulinemia, plasmapheresis can be used as effective adjunt therapy to minimize cutaneous, renal and/or neurologic involvement.
authors.affiliation: Department of Dermatology, Hospital de la Santa Creu i Sant Pau, Spain. avila@hsp.santpau.es
authors.forename: A T
authors.initials: AT
authors.lastname: Vila
authors.forename: M A
authors.initials: MA
authors.lastname: Barnadas
authors.forename: J
authors.initials: J
authors.lastname: Ballarin
authors.forename: R
authors.initials: R
authors.lastname: Garcia
authors.forename: C
authors.initials: C
authors.lastname: Juarez
authors.forename: P
authors.initials: P
authors.lastname: Madoz
authors.forename: E
authors.initials: E
authors.lastname: Ramila
authors.forename: A
authors.initials: A
authors.lastname: Alomar
mesh_terms: D000368:Aged; D003449:Cryoglobulinemia / Q000150:complications* / Q000628:therapy; D003937:Diagnosis, Differential; D004431:Ear, External; D006801:Humans; D008297:Male; D010956:Plasmapheresis; D051437:Renal Insufficiency / Q000150:complications* / Q000628:therapy; D012883:Skin Ulcer / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy