| Erythema elevatum diutinum associated with IgA paraproteinemia successfully controlled with intermittent plasma exchange. | |
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MedLine Citation:
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PMID: 8915315 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: We review the literature and report a case of refractory erythema elevatum diutinum associated with IgA paraproteinemia that was successfully controlled with intermittent plasma exchange (PLEX). OBSERVATIONS: Typical lesions of erythema elevatum diutinum developed in a 72-year-old patient with IgA paraproteinemia; the condition predictably flared whenever IgA levels reached a threshold of 8 g/L. After 8 years of unsuccessful treatment with various agents, we instituted a trial of PLEX during an acute flare. Following 6 exchanges over a period of 2 weeks, the IgA level decreased from 8 to 2 g/L and the skin lesions cleared. Three weeks later, new skin lesions developed and the IgA level had rebounded from 2 to just over 8 g/L. A second course of PLEX was administered, with excellent results, and a 3-month course of oral chlorambucil (2 mg/d) was initiated. The patient's condition remained in clinical remission for 10 months. Over the ensuing 9 years, she suffered 11 further flares, each of which was associated with IgA levels of 8 to 10 g/L and each responding dramatically to 3 to 5 PLEXs followed by a consolidative dose of intravenous cyclophosphamide (250-500 mg). CONCLUSION: We believe that PLEX may have an important role in the management of severe erythema elevatum diutinum associated with monoclonal paraproteinemia refractory to other therapy. |
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Authors:
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R K Chow; W B Benny; R L Coupe; W A Dodd; R C Ongley |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Archives of dermatology Volume: 132 ISSN: 0003-987X ISO Abbreviation: Arch Dermatol Publication Date: 1996 Nov |
Date Detail:
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Created Date: 1996-12-24 Completed Date: 1996-12-24 Revised Date: 2008-03-17 |
Medline Journal Info:
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Nlm Unique ID: 0372433 Medline TA: Arch Dermatol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1360-4 Citation Subset: AIM; IM |
Affiliation:
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Division of Dermatology, University of British Columbia, Vancouver. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Erythema / complications*, therapy* Female Humans Immunoglobulin A* Paraproteinemias / complications*, therapy* Plasma Exchange / methods* |
| Chemical | |
Reg. No./Substance:
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0/Immunoglobulin A |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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