Figure 923

This approach to treatment of the acute renal exacerbations of cryoglobulinemia and vasculitis used previously when the viral cause of the disease was unknown is still valid now that the viral cause is evident. It is a common experience that the antiviral agent interferon-a, when given alone, does not control renal complications in the acute stage of the disease [20].

Steriods are used to control inflammatory renal and systemic involvement Cytotoxic drugs are used to block production of new cryoglobulins by the specific lymphocytic clone that produces the monoclonal immunoglobulin Mk RF, and therefore, the precipitating cryoglobulins Plasma exchange is used to remove circulating cryoglobulins from the blood before they deposit in the glomerulus and arterial walls

Drug

Dosage

Duration

Interferon-a

3.0-6.0 MU, 3 times weekly

6-12 mo

Steriods

Methylprednisolone, 0.75-1.0 g/d, intravenously

3 d

0 0

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