0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Brief Reports |

Resolution of Severe Pyoderma Gangrenosum in a Patient with Streaking Leukocyte Factor Disease after Treatment with Tacrolimus (FK 506)

Kareem Abu-Elmagd, MD; David H. Van Thiel, MD; Brian V. Jegasothy, MD; Jerry C. Jacobs, MD; Patricia Carroll, MD; Horacio Rodriquez-Rilo, MD; Cheryl D. Ackerman, MD; John J. Fung, MD, PhD; and Thomas E. Starzl, MD, PhD
[+] Article and Author Information

From the Pittsburgh Transplant Institute and the University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Columbia University College of Physicians and Surgeons, New York, New York. Requests for Reprints: Kareem Abu-Elmagd, MD, Pittsburgh Transplant Institute, 3601 Fifth Avenue, Falk Clinic 5C, Pittsburgh, PA 15213. Acknowledgments: The authors thank Drs. Ramadan Sha'afi and Kozo Yasui for their help and technical assistance in measuring the serum factor. They also thank Nancy Johnson for patient care and Sharon Wesolowski for preparing the manuscript. Grant Support: In part by research grants from the Veterans Affairs and grant DK29961 from the National Institutes of Health, Bethesda, Maryland


Copyright 2004 by the American College of Physicians


Ann Intern Med. 1993;119(7_Part_1):595-598. doi:10.7326/0003-4819-119-7_Part_1-199310010-00008
Text Size: A A A

Severe, lifelong, unresolving pyoderma gangrenosum occurs in association with recurrent episodes of sterile pyoarthrosis and the presence of a serum factor (called streaking leukocyte factor) [1] responsible for enhancing random migration of purified human neutrophils and mononuclear leukocytes in vitro. Pyoderma gangrenosum is only one feature of this unusual disease. Minor trauma of any sort leads to an excessive accumulation of both mononuclear and polymorphonuclear leukocytes in tissue. This causes subcutaneous induration, sterile abscesses, sterile pyoarthrosis, and extensive areas of skin necrosis similar to those occurring in classical pyoderma gangrenosum, except that the lesions are larger and more confluent. The arthritic lesions are characterized by synovial fluid leukocyte counts greater than 100 000/mm3 and a severe synovitis [1]. We describe a patient with the streaking leukocyte factor syndrome who has been treated successfully with tacrolimus (FK 506, Prograf, Fujisawa Pharmaceutical Co., Osaka, Japan).

First Page Preview

View Large
/>
First page PDF preview

Figures

Grahic Jump Location
Figure 1.
Ulcer in patient with streaking leukocyte factor disease.Left.Right.

A large necrotic ulcer on the front of the lower right thigh region. Marked improvement and healing of the ulcer was noted during 12 weeks of tacrolimus (FK 506) treatment.

Grahic Jump Location

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)