mesna and Rheumatoid-Vasculitis

Rheumatoid vasculitis usually occurs on the background of seropositive rheumatoid arthritis, although in rare cases the patients can be seronegative. We report a woman with seronegative rheumatoid arthritis with rheumatoid vasculitis who developed toxic epidermal necrolysis involving most of her body surface area, while on therapy with intravenous cyclophosphamide and mesna. After withdrawal of suspected offending agents, administration of intravenous immunoglobulin, and supportive therapy, she had a favorable outcome. Such an occurrence is rare and serves to educate about a potentially life-threatening adverse event associated with a commonly used immunosuppressive agent.

Topics: Antirheumatic Agents; Arthritis, Rheumatoid; Cyclophosphamide; Humans; Mesna; Protective Agents; Rheumatoid Vasculitis; Stevens-Johnson Syndrome; Treatment Outcome