[A positive effect of combined therapy (plasmapheresis in combination with pulse therapy) on the course of cryoglobulinemic glomerulonephritis and ulcerative-necrotic vasculitis in patients with Sjögren's disease].

The authors provided evidence of a positive effect of combined therapy (plasmapheresis in combination with pulse-therapy) on a course of cryoglobulinemic glomerulonephritis and ulcerative-necrotic vasculitis in patients with Sjögren's disease (SD). It was shown that plasmapheresis with double plasma filtration considerably decreased the cryoglobulin level in the blood whereas the level of alpha 2-globulins, C-P, RF and CIC did not change 16 hrs after the sessions of plasmapheresis. These indices significantly decreased after pulse-therapy with high doses of 6-methylprednisolone and cyclophosphamide following plasmapheresis. Combined therapy resulted in a complete epithelization of leg ulcers, regression of the symptoms of renal failure. Clinical improvement correlated with a decrease in indices of the inflammatory and immunological activity and with an increase in the cutaneous blood flow. Combined therapy can be an effective therapeutic method of SD complicated by cryoglobulinemic glomerulonephritis and ulcerative-necrotic vasculitis.