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Double-filtration plasmapheresis in the treatment of leg ulcers in cryoglobulinemia

✍ Scribed by A. Ramunni; G. Lauletta; P. Brescia; M.T. Saliani; M. Montrone; M. Chironna; D. Sansonno; F. Dammacco; P. Coratelli

Publisher
John Wiley and Sons
Year
2008
Tongue
English
Weight
182 KB
Volume
23
Category
Article
ISSN
0733-2459

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✦ Synopsis

Abstract

Hepatitis C virus (HCV) is the major cause of cryoglobulinemia. Skin lesions are frequent and can be cured from the removal of cryoglobulins by therapeutic apheresis. We describe a case of HCV‐positive type I cryoglobulinemia with severe leg ulcers, not responsive to antiviral and immunosuppressive treatment. Thirty sessions of double filtration plasmapheresis were performed, over a period of 6 months, with no other associated treatment. Before and after each session an assessment of immunoglobulins, complement, cryocrit, and fibrinogen was made. HCV RNA levels were determined in serum cryoprecipitate, supernatant before and after each session, and in the collection bag. No differences in pre and postapheresis values were observed in the serum concentrations and the supernatant, whereas the postapheresis cryoprecipitate showed a significantly reduced viral load (P < 0.02) as compared with the preapheresis values. There was improvement in the condition of ulcers in the leg during apheresis and had completely regressed by the end of the cycle. J. Clin. Apheresis, 2008. Β© 2008 Wiley‐Liss, Inc.

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