Journal of Thrombosis and Thrombolysis

, Volume 27, Issue 2, pp 220–222

A case of essential mixed cryoglobulinemia and associated acquired von-Willebrand disease treated with rituximab

  • Semir Pasa
  • Abdullah Altintas
  • Timucin Cil
  • Ramazan Danis
  • Orhan Ayyildiz
  • Ekrem Muftuoglu
Article

DOI: 10.1007/s11239-008-0195-0

Cite this article as:
Pasa, S., Altintas, A., Cil, T. et al. J Thromb Thrombolysis (2009) 27: 220. doi:10.1007/s11239-008-0195-0

Abstract

Current treatment options of essential mixed cryoglobulinemia (EMC); include immunosuppressive approaches, such as corticosteroids, cyclophosphamide, plasma exchange, other cytotoxic drugs in moderate to severe manifestations. Some controlled studies have been carried out to assess the efficacy of anti-CD20 monoclonal antibody, rituximab in patients with hepatitis C (HCV) related cryoglobulinemia (CG) and in patients with autoimmune disorders. Recent trials and some case reports demonstrate a beneficial role for rituximab in HCV related mixed CG. Although, the published evidence for treatment of EMC with rituximab is restricted to case reports, which have shown positive results. Several diseases include lymphoproliferative and myeloproliferative disorders, solid tumors, immunological disorders, cardiovascular disorders and some drugs associated with acquired von Willebrand disease (avWD). CG, which is a kind of immune complex disease, may be related with development of autoantibodies to various autoantigens. In this present case report, we showed the efficacy of rituximab in a 21-year-old female patient, suffered from neuropathy and arthralgia related with EMC, and developed avWD, presented with mucosal bleeding associated with CG. von Willebrand factor activity of our patient also increased with controlling the underlying disease, EMC by rituximab. This case demonstrate that rituximab may be an effective treatment option in EMC and avWD mainly related to CG.

Keywords

Essential mixed cryoglobulinemiaAcquired von Willebrand diseaseRituximab

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Semir Pasa
    • 1
  • Abdullah Altintas
    • 1
  • Timucin Cil
    • 2
  • Ramazan Danis
    • 3
  • Orhan Ayyildiz
    • 1
  • Ekrem Muftuoglu
    • 1
  1. 1.Department of Hematology, Medical FacultyDicle UniversityDiyarbakirTurkey
  2. 2.Department of Oncology, Medicine FacultyDicle UniversityDiyarbakirTurkey
  3. 3.Department of Nephrology, Medicine FacultyDicle UniversityDiyarbakirTurkey