Bortezomib in type I cryoglobulinemic vasculitis: are we acting too late?

Intern Med. 2015;54(9):1119-23. doi: 10.2169/internalmedicine.54.3668. Epub 2015 May 1.

Abstract

Type II and type III cryoglobulinemic vasculitis (CV) are characterized by a deranged immune function due to concomitant chronic infections or rheumatic disorders. Conversely, type I CV is caused by plasma cell dyscrasia. Bortezomib is a proteasome inhibitor that is largely employed as a first-line treatment for multiple myeloma. The use of bortezomib in cases of monoclonal gammopathy of undetermined significance (MGUS)-related refractory type I CV has been reported in only four patients. In the current report, we discuss the efficacy of bortezomib treatment in a patient with type I CV, with a focus on the suitability and early application of this drug.

Publication types

  • Case Reports

MeSH terms

  • Amputation, Surgical
  • Antineoplastic Agents / administration & dosage*
  • Bortezomib / administration & dosage*
  • Cryoglobulinemia / complications
  • Cryoglobulinemia / diagnosis
  • Cryoglobulinemia / drug therapy*
  • Early Diagnosis
  • Foot Diseases / drug therapy
  • Foot Diseases / etiology
  • Foot Diseases / surgery*
  • Humans
  • Male
  • Middle Aged
  • Monoclonal Gammopathy of Undetermined Significance
  • Necrosis / etiology
  • Necrosis / surgery*
  • Paraproteinemias / complications
  • Severity of Illness Index
  • Toes / blood supply
  • Toes / pathology
  • Toes / surgery*
  • Treatment Outcome
  • Vasculitis / complications
  • Vasculitis / drug therapy*
  • Vasculitis / etiology

Substances

  • Antineoplastic Agents
  • Bortezomib