A case report of leukocytapheresis for refractory leg ulcers complicated with rheumatoid arthritis.
Leukocytapheresis (LCAP) has recently been investigated for the treatment of drug-resistant rheumatoid arthritis (RA). In the present clinical study, we used LCAP in three patients with rheumatoid arthritis (RA), with drug-resistant leg ulcers. LCAP was carried out once a week for five weeks. Erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor titers and tender joint counts did not change when LCAP was used but the ulcers began to recede after the first treatment and, by the end of the fifth treatment, the ulcers had healed. The activated leukocytes that are the major part of the inflammation of skin ulcers are removed from the peripheral blood by LCAP. Thus, it is supposed that the activated leukocytes shift from the inflammatory skin ulcer to peripheral blood, causing the skin ulcer to recover. We hypothesize that LCAP is a useful treatment for refractory leg ulcers complicated with RA.
Itoh
Yoko
Y
Department of Internal Medicine, National Hospital Organization Sagamihara National Hospital, Sagamihara, Kanagawa, Japan. ezf02550@nifty.com
Takeshita
Yasuyo
Y
Ozawa
Yoshinori
Y
Tohma
Shigeto
S
Umemura
Satoshi
S
D000368:Aged; D001172:Arthritis, Rheumatoid / Q000150:complications*; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000150:complications* / Q000628:therapy; D007937:Leukapheresis; D007958:Leukocyte Count; D008875:Middle Aged; D012217:Rheumatoid Factor / Q000097:blood; D013817:Thermography
D002097:C-Reactive Protein; D012217:Rheumatoid Factor