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Vol. 4. Issue 2.
Pages 55-58 (March - April 2008)
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Vol. 4. Issue 2.
Pages 55-58 (March - April 2008)
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Eosynophilic Fasciitis. Favorable Response to Treatment With Cyclosporin A
Fascitis eosinofílica, respuesta favorable al tratamiento con ciclosporina A
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Jorge Jaimes-Hernándeza,
Corresponding author
jorjaimes@yahoo.com

Correspondence: Centro Médico ISSEMYM. Avda. Baja Velocidad, Paseo Tollocan 284, 5.° piso. San Jerónimo Chicahualco. Metepec. Estado de México. C.P. 52140. México.
, Claudia Irene Meléndez-Mercadob, Pablo Aranda-Pereirab
a División de Medicina Interna, Departamento de Reumatología, Centro Médico ISSEMyM, Metepec, Estado de Mexico, Mexico
b Departamento de Reumatología, Centro Médico ISSEMyM, Metepec, Estado de Mexico, Mexico
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Introduction

Eosinophilic fasciitis (EF) is a disease of unknown aetiology characterized by cutaneous swelling and indurations. The disease affects predominantly the extremities and usually show an elevation of serum immunoglobulins, and eosinophilia.

Objective

Evaluation of the efficacy of cyclosporine A as a therapeutic alternative in patients with EF refractory to steroids.

Patients and method

We report 3 patients with clinical, laboratory and pathologic characteristics of EF who did not show a satisfactory response to steroids treatment. All patients disclosed scleroderma-like signs with orange skin, groove sign, and indurations of the affected extremities associated to peipheral eosinophilia and increased creatine-kinase. Epidermis histological findings were normal and intense linfocitary inflammation of the fascia was observed in all patients’ biopsies. All patients were treated for average of 8 months with prednisone 30–50mg daily with an insufficient clinical response.

Results

Patients started on cyclosporine A 5-7mg/kg/day, showing a fast improvement (2 months). The treatment induces a clinical remission that permits to reduce or even stops the cyclosporine A treatment during follow-up.

Conclusions

It seems that cyclosporine A may be a effective therapeutic alternative in patients with EF refractory to steroids.

Key words:
Eosinophilic fasciitis
Cyclosporine A
Treatment
Introducción

La fascitis eosinofílica (FE) es una enfermedad de origen desconocido, caracterizada por induración de la piel, debido a inflamación de las fascias del tejido conjuntivo. Afecta principalmente a las extremidades y se acompaña de elevación de inmunoglobulinas y eosinofilia periférica.

Objetivo

Evaluar la eficacia de ciclosporina A en pacientes con FE con resistencia al tratamiento convencional con glucocorticoides. Pacientes y método Presentamos 3 pacientes con manifestaciones clínicas y serológicas de FE que tuvieron resistencia al tratamiento estándar con glucocorticoides (30 a 50mg/día, durante un período de hasta 8 meses). Las manifestaciones clínicas principales fueron: induración de la piel de las extremidades y el tronco que se acompañó de eosinofilia periférica y elevación de la creatincinasa. Histológicamente se observó un engrosamiento con intensa inflamación linfocitaria de las fascias.

Resultados

Todos los pacientes fueron tratados con ciclosporina A, a dosis de 5 a 7mg/kg/día con una rápida mejoría clínica (2 meses). El tratamiento condujo, en todos los casos, a una remisión clínica que permitió reducir e incluso retirar la ciclosporina A durante el seguimiento.

Conclusiones

La ciclosporina A parece una alternativa terapéutica eficaz en el tratamiento de pacientes con FE resistente a glucocorticoides.

Palabras clave:
Fascitis eosinofílica
Ciclosporina A
Tratamiento
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Copyright © 2008. Sociedad Española de Reumatología and Colegio Mexicano de Reumatología
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