Annals of Hematology

, Volume 84, Issue 9, pp 609–613

Successful management of cryoglobulinemia-induced leukocytoclastic vasculitis with thalidomide in a patient with multiple myeloma

  • M. Cem Ar
  • Teoman Soysal
  • Gulen Hatemi
  • Ayse Salihoglu
  • Hasan Yazici
  • Birsen Ulku
Short Communication

DOI: 10.1007/s00277-005-1053-1

Cite this article as:
Cem Ar, M., Soysal, T., Hatemi, G. et al. Ann Hematol (2005) 84: 609. doi:10.1007/s00277-005-1053-1

Abstract

Leukocytoclastic vasculitis (LV) is a systemic inflammatory disorder involving mostly the small vessels. It is characterised by segmental angiocentric neutrophilic inflammation, endothelial cell damage and fibrinoid necrosis. LV is related to a variety of clinical disorders including cryoglobulinemia and, very rarely, multiple myeloma (MM), among many others. The development of LV in patients with MM has been linked to cryoglobulinemia, infections, drugs and paraneoplasia. It has been speculated that myeloma patients with a poorer prognosis and progressive disease are more prone to develop LV. Thalidomide is a rediscovered old drug with anti-angiogenic, immunomodulatory and anti-inflammatory properties. It is highly effective in the treatment of MM and other clinical disorders such as leprosy, various cancers, graft-versus-host disease and autoimmune diseases. We report here a female patient with Durie–Salmon stage IIA MM who initially presented with cryoglobulinemia and LV. LV in this patient was primarily considered to be the result of progressive cryoglobulinemia, which was closely associated with MM. She was successfully managed with thalidomide and dexamethasone.

Keywords

Leukocytoclastic vasculitisThalidomideCryoglobulinemiaMultiple myeloma

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • M. Cem Ar
    • 1
  • Teoman Soysal
    • 1
  • Gulen Hatemi
    • 2
  • Ayse Salihoglu
    • 3
  • Hasan Yazici
    • 2
  • Birsen Ulku
    • 1
  1. 1.Department of Internal Medicine, Division of Haematology, Cerrahpasa Medical FacultyIstanbul UniversityIstanbulTurkey
  2. 2.Department of Internal Medicine, Division of Rheumatology, Cerrahpasa Medical FacultyIstanbul UniversityIstanbulTurkey
  3. 3.Department of Internal Medicine, Cerrahpasa Medical FacultyIstanbul UniversityIstanbulTurkey