Document 0395
 DOCN  M9590395
 TI    Leukocytoclastic vasculitis following staphylococcal protein A column
       immunoadsorption therapy. Two cases and a review of the literature.
 DT    9509
 AU    Arbiser JL; Dzieczkowski JS; Harmon JV; Duncan LM; Department of
       Dermatology, Massachusetts General Hospital and; Harvard Medical School,
       Boston, USA.
 SO    Arch Dermatol. 1995 Jun;131(6):707-9. Unique Identifier : AIDSLINE
       MED/95297854
 AB    BACKGROUND: Protein A immunoadsorption is a novel therapy for the
       treatment of diseases mediated by pathogenic autoantibodies. This
       procedure consists of circulating patients' plasma through a column
       containing staphylococcal protein A, which binds to the Fc portion of
       IgG, enabling removal of IgG. Presently, protein A immunoadsorption is
       used in the treatment of idiopathic thrombocytopenic purpura, but may be
       more widely used as an immunomodulator in human immunodeficiency virus
       infection and metastatic carcinoma. OBSERVATIONS: We present two
       histologically documented cases of leukocytoclastic vasculitis in the
       setting of protein A immunoadsorption. This potentially severe adverse
       effect is probably more common than the literature reflects and should
       be recognized by physicians who are treating patients with protein A
       column pheresis. CONCLUSIONS: The pathogenesis of protein A
       therapy-associated leukocytoclastic vasculitis remains unclear. Further
       study of vasculitis in the setting of protein A column pheresis may lead
       to modifications of this therapy, resulting in fewer adverse effects.
       Protein A-associated leukocytoclastic vasculitis may serve as a useful
       model of the relation of immune complexes and vasculitis.
 DE    Aged  Ataxia/IMMUNOLOGY/THERAPY  Autoantibodies/IMMUNOLOGY  Case Report
       Female  Human  Immunosorbent Techniques/*ADVERSE EFFECTS  Male  Middle
       Age  Purkinje Cells/IMMUNOLOGY  Purpura, Thrombocytopenic/THERAPY
       Staphylococcal Protein A/*ADVERSE EFFECTS/THERAPEUTIC USE  Vasculitis,
       Hypersensitivity/*ETIOLOGY  JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).