ABSTRACT
Hidradenitis suppurativa (HS) affects the apocrine sweat glands, giving chronic recurrent abscesses of axillary and perineal areas. We report a patient who had a defect in polymorphonuclear leukocyte killing of bacteria associated with low levels of intracellular cyclic GMP. This defect was corrected with a cholinergic agonist in vitro. Treatment of the patient with a cholinergic agonist, bethanechol chloride, resulted in prolonged clinical improvement, normal bactericidal function, and normal levels of intracellular cyclic GMP. The possible mechanisms responsible for the bactericidal defect and for the patient's improvement are discussed.
Subject(s)
Bethanechol Compounds/therapeutic use , Blood Bactericidal Activity/drug effects , Parasympathomimetics/therapeutic use , Sweat Gland Diseases/immunology , Aged , B-Lymphocytes , Bethanechol , Carbachol/therapeutic use , Chemotaxis, Leukocyte , Humans , Inflammation/drug therapy , Inflammation/immunology , Leukocyte Count , Lymphocyte Activation , Male , Neutrophils , Nucleotides, Cyclic/biosynthesis , Sweat Gland Diseases/drug therapy , T-LymphocytesSubject(s)
Cryoglobulinemia/therapy , Paraproteinemias/therapy , Plasmapheresis , Adult , Aged , Humans , Middle AgedABSTRACT
The efficacy of plasmapheresis in a patient with mixed cryoglobulinemia and pancytopenia is shown. The cryoglobulin was shown to have percursor cell suppressing activity and its depletion by plasmapheresis resulted in improvement of blood counts, Indications, limitations and guidelines for plasmapheresis in various diseases are discussed.
