Combination therapy of prednisolone and mizoribine improves cryoglobulinemic vasculitis with purpura and skin ulcers

Clin Rheumatol. 2007 Jul;26(7):1170-2. doi: 10.1007/s10067-006-0295-1. Epub 2006 Apr 14.

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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Cryoglobulinemia / complications
  • Cryoglobulinemia / drug therapy*
  • Cryoglobulinemia / pathology
  • Drug Therapy, Combination
  • Female
  • Glucocorticoids / therapeutic use*
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Prednisolone / therapeutic use*
  • Purpura, Hyperglobulinemic / complications
  • Purpura, Hyperglobulinemic / drug therapy
  • Purpura, Hyperglobulinemic / pathology
  • Ribonucleosides / therapeutic use*
  • Skin Ulcer / complications
  • Skin Ulcer / drug therapy*
  • Skin Ulcer / pathology
  • Treatment Outcome
  • Vasculitis / complications
  • Vasculitis / drug therapy
  • Vasculitis / pathology

Substances

  • Glucocorticoids
  • Immunosuppressive Agents
  • Ribonucleosides
  • mizoribine
  • Prednisolone