Cytophagic histiocytic panniculitis improved by combined CHOP and cyclosporin A treatment.

Abstract

In a 31-year-old Japanese man with cytophagic histiocytic panniculitis (CHP) remission was achieved by a combination of combined chemotherapy CHOP and cyclosporin A treatment. He was admitted to our hospital in January 1994 with recurrent high fever of 40.2 degrees C and tender and violaceous subcutaneous nodules on his trunk, arms and legs. He developed pancytopenia, hemorrhagic diathesis, liver dysfunction. Histological examination of the biopsied subcutaneous nodule revealed a lobular panniculitis with fat necrosis and a massive infiltration of histiocytes phagocytosing nuclear debris. He was treated initially with 40 mg/day prednisolone. However, following a reduction in prednisolone dosage, his symptoms reappeared. CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone) therapy was then initiated. Three courses of CHOP treatment alleviated his symptoms and cyclosporin A was used to maintain his condition for 15 months. His medication was then discontinued and he has been in complete remission for 10 months. Combined treatment of cyclosporin A and CHOP combined chemotherapy was shown to be effective for this patient with severe CHP.

• Authors: M Ito, H Ohira, M Miyata, T Suzuki, Y Sato, S Kaise, T Nishimaki, H Sakuma, Y Nihei, K Iwatsuki, R Kasukawa
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 38 Issue 3 Pg. 296-301 (Mar 1999) ISSN: 0918-2918 [Print] Japan
• PMID: 10337947 (Publication Type: Case Reports, Journal Article)

Chemical References

• Immunosuppressive Agents
• Vincristine
• Doxorubicin
• Cyclosporine
• Cyclophosphamide
• Prednisone

Topics

• Adult
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Biopsy
• Cyclophosphamide (therapeutic use)
• Cyclosporine (therapeutic use)
• Doxorubicin (therapeutic use)
• Drug Therapy, Combination
• Fat Necrosis (drug therapy, pathology)
• Follow-Up Studies
• Histiocytosis (drug therapy, pathology)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Male
• Panniculitis, Nodular Nonsuppurative (drug therapy, pathology)
• Phagocytosis
• Prednisone (therapeutic use)
• Recurrence
• Vincristine (therapeutic use)