1. Mycophenolate mofetil and mycophenolic acid for the treatment of eosinophilic fasciitis: report of two cases and literature review
- Author
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Adrian Cuellar-Barboza, Janett Riega-Torres, Jorge A. Esquivel-Valerio, Ilse Andrea Moreno-Arquieta, Jorge Ocampo-Candiani, Jesus Alberto Cardenas-de la Garza, Maira Elizabeth Herz-Ruelas, and Dionicio Ángel Galarza-Delgado
- Subjects
medicine.medical_specialty ,Erythema ,Dermatology ,Mycophenolate ,Mycophenolic acid ,Autoimmune Diseases ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Edema ,medicine ,Humans ,Fasciitis ,Glucocorticoids ,030203 arthritis & rheumatology ,business.industry ,Mycophenolic Acid ,medicine.disease ,Autoimmune connective tissue disorder ,Eosinophilic fasciitis ,Shulman syndrome ,nervous system ,medicine.symptom ,business ,Immunosuppressive Agents ,medicine.drug - Abstract
Eosinophilic fasciitis (EF) is an uncommon autoimmune connective tissue disorder characterized by edema, erythema, and subsequent induration of the extremities. It is commonly treated with corticosteroids but there is no treatment ladder for immunosuppressants or steroid-sparing agents. We report two EF cases treated effectively with mycophenolate mofetil (MMF) or mycophenolic acid (MPA) and present a literature review. We performed a MEDLINE search using the keywords 'eosinophilic fasciitis', 'Shulman syndrome', 'mycophenolic acid', or 'mofetil mycophenolate', and found 8 articles with 27 cases in which MMF or MPA was used. Twenty-nine cases were reviewed (2 reported herein and 27 from the literature search); all patients received a combination of systemic corticosteroids and MMF. MMF/MPA were given as a steroid-sparing agent in 27 (93.1%), in 1 (3.4%) as adjunctive therapy with other immunosuppressants, and in one, as monotherapy 1 (3.4%). Nineteen had a complete response, 6, a partial response, and 2 were unresponsive to diverse immunomodulators; in 2 cases, the outcome was not reported. MMF and MPA show promising therapeutic results and could be a treatment option to reduce corticosteroid related side effects.
- Published
- 2021
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