A Case of Subacute Cutaneous Lupus Erythematosus in a Patient with Mixed Connective Tissue Disease: Successful Treatment with Plasmapheresis and Rituximab
A 30-year-old woman affected by Mixed Connective Tissue Disease with scleroderma spectrum developed a facial eruption, a clinical and histological characteristic of subacute cutaneous lupus erythematosus (SCLE). Speckled anti-nuclear antibodies, high-titer anti-ribonucleoprotein1, anti-Sm, anti-Card...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Case Reports in Rheumatology |
| Online Access: | http://dx.doi.org/10.1155/2013/857694 |
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| author | M. Fantò S. Salemi F. Socciarelli A. Bartolazzi G. A. Natale I. Casorelli A. Pavan S. Vaglio R. Di Rosa R. D'Amelio |
| author_facet | M. Fantò S. Salemi F. Socciarelli A. Bartolazzi G. A. Natale I. Casorelli A. Pavan S. Vaglio R. Di Rosa R. D'Amelio |
| author_sort | M. Fantò |
| collection | DOAJ |
| description | A 30-year-old woman affected by Mixed Connective Tissue Disease with scleroderma spectrum developed a facial eruption, a clinical and histological characteristic of subacute cutaneous lupus erythematosus (SCLE). Speckled anti-nuclear antibodies, high-titer anti-ribonucleoprotein1, anti-Sm, anti-Cardiolipin (aCL) IgG/IgM, and anti-Ro/SSA antibodies were positive. SCLE was resistant to Azathioprine, Hydroxychloroquine, and Methotrexate while Mycophenolate Mofetil was suspended due to side effects. Subsequently, the patient was treated with three cycles of therapeutic plasma exchange (TPE) followed, one month after the last TPE, by the anti-CD20 antibody Rituximab (RTX) (375 mg/m2 weekly for 4 weeks). Eight and 16 months later the patient received other two TPE and RTX cycles, respectively. This therapeutic approach has allowed to obtain a complete skin healing persistent even after 8-month follow-up. Moreover, mitigation of Raynaud's phenomenon, resolution of alopecia, and a decline of aCL IgG/IgM and anti-Ro/SSA antibodies were observed. |
| format | Article |
| id | doaj-art-f8ff4acd6afe423f8f12bdfa3ad65573 |
| institution | Kabale University |
| issn | 2090-6889 2090-6897 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Rheumatology |
| spelling | doaj-art-f8ff4acd6afe423f8f12bdfa3ad655732025-02-03T06:07:51ZengWileyCase Reports in Rheumatology2090-68892090-68972013-01-01201310.1155/2013/857694857694A Case of Subacute Cutaneous Lupus Erythematosus in a Patient with Mixed Connective Tissue Disease: Successful Treatment with Plasmapheresis and RituximabM. Fantò0S. Salemi1F. Socciarelli2A. Bartolazzi3G. A. Natale4I. Casorelli5A. Pavan6S. Vaglio7R. Di Rosa8R. D'Amelio9Department of Allergy, Clinical Immunology and Rheumatology, S. Andrea Hospital, Sapienza University of Rome, ItalyDepartment of Allergy, Clinical Immunology and Rheumatology, S. Andrea Hospital, Sapienza University of Rome, ItalyDepartment of Pathology, S. Andrea Hospital, Sapienza University of Rome, ItalyDepartment of Pathology, S. Andrea Hospital, Sapienza University of Rome, ItalyDepartment of Immunohematology and Transfusion Unit, S. Andrea Hospital, Sapienza University of Rome, ItalyDepartment of Immunohematology and Transfusion Unit, S. Andrea Hospital, Sapienza University of Rome, ItalyDepartment of Immunohematology and Transfusion Unit, S. Andrea Hospital, Sapienza University of Rome, ItalyDepartment of Immunohematology and Transfusion Unit, S. Andrea Hospital, Sapienza University of Rome, ItalyDepartment of Allergy, Clinical Immunology and Rheumatology, S. Andrea Hospital, Sapienza University of Rome, ItalyDepartment of Allergy, Clinical Immunology and Rheumatology, S. Andrea Hospital, Sapienza University of Rome, ItalyA 30-year-old woman affected by Mixed Connective Tissue Disease with scleroderma spectrum developed a facial eruption, a clinical and histological characteristic of subacute cutaneous lupus erythematosus (SCLE). Speckled anti-nuclear antibodies, high-titer anti-ribonucleoprotein1, anti-Sm, anti-Cardiolipin (aCL) IgG/IgM, and anti-Ro/SSA antibodies were positive. SCLE was resistant to Azathioprine, Hydroxychloroquine, and Methotrexate while Mycophenolate Mofetil was suspended due to side effects. Subsequently, the patient was treated with three cycles of therapeutic plasma exchange (TPE) followed, one month after the last TPE, by the anti-CD20 antibody Rituximab (RTX) (375 mg/m2 weekly for 4 weeks). Eight and 16 months later the patient received other two TPE and RTX cycles, respectively. This therapeutic approach has allowed to obtain a complete skin healing persistent even after 8-month follow-up. Moreover, mitigation of Raynaud's phenomenon, resolution of alopecia, and a decline of aCL IgG/IgM and anti-Ro/SSA antibodies were observed.http://dx.doi.org/10.1155/2013/857694 |
| spellingShingle | M. Fantò S. Salemi F. Socciarelli A. Bartolazzi G. A. Natale I. Casorelli A. Pavan S. Vaglio R. Di Rosa R. D'Amelio A Case of Subacute Cutaneous Lupus Erythematosus in a Patient with Mixed Connective Tissue Disease: Successful Treatment with Plasmapheresis and Rituximab Case Reports in Rheumatology |
| title | A Case of Subacute Cutaneous Lupus Erythematosus in a Patient with Mixed Connective Tissue Disease: Successful Treatment with Plasmapheresis and Rituximab |
| title_full | A Case of Subacute Cutaneous Lupus Erythematosus in a Patient with Mixed Connective Tissue Disease: Successful Treatment with Plasmapheresis and Rituximab |
| title_fullStr | A Case of Subacute Cutaneous Lupus Erythematosus in a Patient with Mixed Connective Tissue Disease: Successful Treatment with Plasmapheresis and Rituximab |
| title_full_unstemmed | A Case of Subacute Cutaneous Lupus Erythematosus in a Patient with Mixed Connective Tissue Disease: Successful Treatment with Plasmapheresis and Rituximab |
| title_short | A Case of Subacute Cutaneous Lupus Erythematosus in a Patient with Mixed Connective Tissue Disease: Successful Treatment with Plasmapheresis and Rituximab |
| title_sort | case of subacute cutaneous lupus erythematosus in a patient with mixed connective tissue disease successful treatment with plasmapheresis and rituximab |
| url | http://dx.doi.org/10.1155/2013/857694 |
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