INTRODUCTION: Type II mixed cryoglobulin syndrome is a systematic vasculitis mainly linked to immune complex deposition in several organs and to hepatitis C virus infection. Therapeutic strategies can target either the viral trigger hepatitis C virus if present, or pathogenic events downstream the triggering infection, e.g, the proliferation B-cells directly. Antiviral therapy should be considered as a first-line treatment in many HCV-positive patients. However, it may prove ineffective, contraindicated, or poorly tolerated. The other available treatment [such as cytotoxic agents, steroids] may lead to life-threatening complications and may be difficult to manage in the long term.CASE PRESENTATION: We report on a 75-year-old patient with long-lasting hepatitis C virus infection [18 years], a long-lasting cryoglobulinemia [7 years] resistant to common antiviral therapy, diabetes mellitus and deep skin ulcers, successfully treated with the combination therapy of Rituximab and plasma exchange.CONCLUSION: Plasma exchange in combination with Rituximab may be useful to heal skin in those patients who are non responsive to Rituximab alone, by avoiding a leg amputation.
Successful combination of Rituximab and plasma exchange in the treatment of cryoglobulinemic vasculitis with skin ulcers: a case report
GIAQUINTA A;VEROUX, Pierfrancesco;VEROUX, Massimiliano
2009-01-01
Abstract
INTRODUCTION: Type II mixed cryoglobulin syndrome is a systematic vasculitis mainly linked to immune complex deposition in several organs and to hepatitis C virus infection. Therapeutic strategies can target either the viral trigger hepatitis C virus if present, or pathogenic events downstream the triggering infection, e.g, the proliferation B-cells directly. Antiviral therapy should be considered as a first-line treatment in many HCV-positive patients. However, it may prove ineffective, contraindicated, or poorly tolerated. The other available treatment [such as cytotoxic agents, steroids] may lead to life-threatening complications and may be difficult to manage in the long term.CASE PRESENTATION: We report on a 75-year-old patient with long-lasting hepatitis C virus infection [18 years], a long-lasting cryoglobulinemia [7 years] resistant to common antiviral therapy, diabetes mellitus and deep skin ulcers, successfully treated with the combination therapy of Rituximab and plasma exchange.CONCLUSION: Plasma exchange in combination with Rituximab may be useful to heal skin in those patients who are non responsive to Rituximab alone, by avoiding a leg amputation.File | Dimensione | Formato | |
---|---|---|---|
rituximab cases j.pdf
accesso aperto
Tipologia:
Versione Editoriale (PDF)
Licenza:
Non specificato
Dimensione
293.59 kB
Formato
Adobe PDF
|
293.59 kB | Adobe PDF | Visualizza/Apri |
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.