1991 Volume 14 Issue 2 Pages 203-210
We report a 27-year-old female of severe hypersensitivity vasculitis, who was successfully treated with immunoadsorbent therapy. She complained of purpura, polyarthralgia and cough in September, 1988. She was admitted to our hospital because of the deterioration of these symptoms and the following laboratory data became available.
1. There was palpable purpura on the bilateral legs and arms. Skin biopsy showed leukocytoclastic vasculitis.
2. Hb was 7.2g/dl, ESR 100mm/hr, PaO2 66mmHg. Abnormal serum values were IgG 3, 865mg/dl, immune complexes 61μg/dl and hypocomplementemia.
3. Renal biopsy showed granular deposition of Clq and IgG within the vessel walls of capillaries.
4. Respiratory function test revealed the decrease of % FEV1.0 and DLco. Her chest X-ray depicted reticular shadow in the bilateral leg base.
She was diagnosed as having severe hypersensitivity vasculitis with multiple organ involvement. She was treated with prednisolone 60mg/day but her clinical course was complicated with pulmonary hemorrhage. Immunoadsorption therapy with PH-350 column (Asahi Medical) was carried out to lower the serum level of immune complexes. After the immunoadsorption, treatment with prednisolone was continued and her condition got better.
Immunoadsorbent therapy using column with immobilized phenylalanine as ligand was effective for severe hypersensitivity vasculitis with high level of serum immune complexes and the involvement of multiple organs.
