Severe leukocytoclastic vasculitis of the skin in a patient with essential mixed cryoglobulinemia treated with high-dose gamma-globulin intravenously.

We describe a patient with long-standing severe leukocytoclastic vasculitis of the skin and essential mixed cryoglobulinemia type II, who showed a limited reaction to immunosuppressive drugs, plasmapheresis, and colchicine. Therapy with high-dose gamma-globulin intravenously (IV) for five days resulted in disappearance of vasculitis lesions within three weeks. After gamma-globulin IV treatment there was a decrease in cryoglobulin, circulating immune complexes, and IgM, paraprotein, and a rise in complement levels. No serious side effects were noted during or after gamma-globulin IV treatment. The patient has been in remission for 16 months.