Open AccessType I cryoglobulinemic vasulitis with eosinophilia
Author(s) -
Jing-jing Wen,
Fang Xu,
Min Li,
Qiaoling Zhou,
Quan Wen,
Yiping Liu,
Jing Su,
Hong Hu
Publication year - 2019
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000016382
Subject(s) - medicine , cryoglobulinemia , eosinophilia , prednisone , rituximab , cyclophosphamide , dermatology , cryoglobulin , plasmapheresis , multiple myeloma , monoclonal gammopathy of undetermined significance , immunology , monoclonal , pathology , gastroenterology , lymphoma , chemotherapy , antibody , monoclonal antibody , hepatitis c virus , virus
Rationale: Type I monoclonal cryoglobulinemia is usually associated with lymphoproliferative disorders, such as monoclonal gammopathy of undetermined significance (MGUS), myeloma, chronic lymphocytic leukemia (CLL) and lymphoplasmocytic lymphoma (LPL). Clinical symptoms related to Type I cryoglobulin (CG) isotype often include skin, neurological and renal manifestations. Patient concerns: A 42-year-old woman who initially presented urticaria, palpable purpura in both her upper extremities and legs, eosinophilia and Raynaud phenomenon. Skin biopsy revealed eosinophil infiltration. Monoclonal immunoglobulin (Ig) G-κprotein was detected and CG was also positive. Diagnoses: The patient was finally diagnosed as MGUS related Type I CG. Interventions: Cyclophosphamide-dexamethasone-thalidomide (CDT) therapy was initiated. Outcomes: The treatment relieved the skin symptoms efficiently. Lessons: To our knowledge, this is a rare case of Type I cryoglobulinemic vasulitis with eosinophilia complicated by MGUS, and the effective treatment of cyclophosphamide combined with thalidomide and prednisone may provide a new therapeutic option for cryoglobulinemic vasulitis.