title: Cryoglobulinemic vasculitis in systemic sclerosis successfully treated with mycophenolate mofetil.
abstract: Cryoglobulinemic vasculitis is extremely rare in patients with systemic sclerosis (SSc). So far, only two cases of cryoglobulinemic vasculitis in SSc were described in the literature. This report is about a patient with SSc and secondary Sjőgren's syndrome, who developed typical clinical features of small-vessel vasculitis, including arthritis, purpura, microhaematuria, gangrene of fingers, and toes and myocardial ischemia, in the presence of mixed cryoglobulinemia, ANA, rheumatoid factor, and anti-SSA/Ro antibodies. Symptoms and signs of vasculitis worsened despite initial treatment with corticosteroids and cyclophosphamide, but improved significantly when mycophenolate mofetil was used instead cyclophosphamide.
authors.affiliation: School of Medicine, Institute of Rheumatology, University of Belgrade, Resavska 69, 11000, Belgrade, Serbia, ostojic@vektor.net.
authors.forename: Predrag
authors.initials: P
authors.lastname: Ostojic
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000368:Aged; D003449:Cryoglobulinemia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D003520:Cyclophosphamide / Q000009:adverse effects; D057915:Drug Substitution; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D045743:Scleroderma, Diffuse / Q000150:complications; D012859:Sjogren's Syndrome / Q000209:etiology; D016896:Treatment Outcome; D014657:Vasculitis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D003520:Cyclophosphamide; D009173:Mycophenolic Acid