Document Detail


Erythema elevatum diutinum associated with IgA paraproteinemia successfully controlled with intermittent plasma exchange.
MedLine Citation:
PMID:  8915315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
R K Chow; W B Benny; R L Coupe; W A Dodd; R C Ongley
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Archives of dermatology     Volume:  132     ISSN:  0003-987X     ISO Abbreviation:  Arch Dermatol     Publication Date:  1996 Nov 
Date Detail:
Created Date:  1996-12-24     Completed Date:  1996-12-24     Revised Date:  2008-03-17    
Medline Journal Info:
Nlm Unique ID:  0372433     Medline TA:  Arch Dermatol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1360-4     Citation Subset:  AIM; IM    
Affiliation:
Division of Dermatology, University of British Columbia, Vancouver.
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MeSH Terms
Descriptor/Qualifier:
Aged
Erythema / complications*,  therapy*
Female
Humans
Immunoglobulin A*
Paraproteinemias / complications*,  therapy*
Plasma Exchange / methods*
Chemical
Reg. No./Substance:
0/Immunoglobulin A

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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