Cytophagic histiocytic panniculitis improved by combined CHOP and cyclosporin A treatment

Intern Med. 1999 Mar;38(3):296-301. doi: 10.2169/internalmedicine.38.296.

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.

Publication types

  • Case Reports

MeSH terms

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

Substances

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

Supplementary concepts

  • CHOP protocol