02060nas a2200325   4500000000100000008004100001260001300042653002100055653001800076653002300094653003000117653001100147653001100158653001600169653002100185653002400206653001600230653004400246100001300290700001300303700001300316700001600329700001300345700001100358245013500369300001100504490000700515520119800522022001401720       2005                            d  c2005 Sep10aCryoglobulinemia10aDexamethasone10aDisease Management10aDrug Therapy, Combination10aFemale10aHumans10aMiddle Aged10aMultiple Myeloma10aRemission Induction10aThalidomide10aVasculitis, Leukocytoclastic, Cutaneous1 aCem Ar M1 aSoysal T1 aHatemi G1 aSalihoglu A1 aYazici H1 aUlku B00aSuccessful management of cryoglobulinemia-induced leukocytoclastic vasculitis with thalidomide in a patient with multiple myeloma.  a609-130 v843 a<p>Leukocytoclastic vasculitis (LV) is a systemic inflammatory disorder involving mostly the small vessels. It is characterised by segmental angiocentric neutrophilic inflammation, endothelial cell damage and fibrinoid necrosis. LV is related to a variety of clinical disorders including cryoglobulinemia and, very rarely, multiple myeloma (MM), among many others. The development of LV in patients with MM has been linked to cryoglobulinemia, infections, drugs and paraneoplasia. It has been speculated that myeloma patients with a poorer prognosis and progressive disease are more prone to develop LV. Thalidomide is a rediscovered old drug with anti-angiogenic, immunomodulatory and anti-inflammatory properties. It is highly effective in the treatment of MM and other clinical disorders such as leprosy, various cancers, graft-versus-host disease and autoimmune diseases. We report here a female patient with Durie-Salmon stage IIA MM who initially presented with cryoglobulinemia and LV. LV in this patient was primarily considered to be the result of progressive cryoglobulinemia, which was closely associated with MM. She was successfully managed with thalidomide and dexamethasone.</p>  a0939-5555