title: Combination therapy of prednisolone and mizoribine improves cryoglobulinemic vasculitis with purpura and skin ulcers.
abstract: Conventional treatment is not standardized for hepatitis C virus-negative cryoglobulinemia, but corticosteroids, immunosuppressive agents, and plasma exchange typically improved the symptoms. Mizoribine is an immunosuppressive agent that was developed in Japan and has been found to inhibit the proliferation of lymphocytes, especially B cells. We have encountered an elder patient who had hepatitis C virus-negative, type II cryoglobulinemic vasculitis with leg purpura and skin ulcers. Her symptoms improved and cryoglobulin disappeared by the combination therapy of prednisolone and mizoribine. We speculate the action mechanism of this therapy is due to immunosuppressive effects including up-regulation of the efficacy of prednisolone by mizoribine.
authors.affiliation: Inflammation and Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kyoto, 602-8566, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Hamaguchi
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kawahito
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Tsubouchi
authors.forename: Masataka
authors.initials: M
authors.lastname: Kohno
authors.forename: Aihiro
authors.initials: A
authors.lastname: Yamamoto
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Ishino
authors.forename: Makoto
authors.initials: M
authors.lastname: Wada
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Yoshikawa
mesh_terms: D000368:Aged; D003449:Cryoglobulinemia / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D011239:Prednisolone / Q000627:therapeutic use*; D011694:Purpura, Hyperglobulinemic / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D012263:Ribonucleosides / Q000627:therapeutic use*; D012883:Skin Ulcer / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D014657:Vasculitis / Q000150:complications / Q000188:drug therapy / Q000473:pathology
chemical_list: D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D012263:Ribonucleosides; C010052:mizoribine; D011239:Prednisolone