Cryoglobulinemic vasculitis resistant to intermittent intravenous pulse cyclophosphamide therapy

We report on a 78-year-old patient with severe disease manifestations including polyneuropathy and clinically suspected secondary temporal arteritis due to hepatitis C virus-associated cryoglobulinemic vasculitis (CV). Despite intermittent intravenous pulse cyclophosphamide therapy and oral corticosteroid therapy her condition further deteriorated. Only oral cyclophosphamide therapy with high-dose corticosteroid and plasmapheresis was efficient in inducing a remission of her CV. This case report demonstrates that pulse cyclophosphamide therapy may not be sufficient to control severe manifestations of cryoglobulinemic vasculitis.