Successful Desensitization to Lenalidomide in Leukocytoclastic Vasculitis

• Published in: Journal of investigational allergology & clinical immunology Vol. 34; no. 5
• Main Authors: Fernández-Concha, I, Pose, K, de Las Vecillas, L, Lluch-Bernal, M, Tomás-Pérez, M, Soto, T, López de la Guía, A, Cabañas, R
• Format: Journal Article
• Language: English
• Published: Spain Esmon Publicidad 01-01-2024
• Subjects: Asthenia; Corticosteroids; Medical treatment; Multiple myeloma; Patients; Purpura; Remission; Vasculitis; Leukocytoclastic vasculitis; Desensitization protocol; Lenalidomide; Multiple myeloma
• ISSN: 1018-9068; 1698-0808
• DOI: 10.18176/jiaci.1002

This abstract presents a case report of successful desensitization to lenalidomide in a patient with leukocytoclastic vasculitis (LV) associated with multiple myeloma (MM). LV is a cutaneous small-vessel vasculitis characterized by palpable purpura and immune complex deposition. Lenalidomide is a standard treatment for MM but can rarely induce LV. The patient initially experienced symptoms of asthenia, back pain, and purpuric lesions after starting lenalidomide, leading to its discontinuation. The patient was successfully treated with corticosteroids and switched to a different treatment regimen. However, due to relapse, lenalidomide was reintroduced using a desensitization protocol. The protocol encountered challenges, but the patient eventually tolerated a daily dose of 10 mg of lenalidomide without corticosteroids. The patient's MM remains in clinical remission. This case highlights the importance of desensitization in managing drug-induced LV and its positive impact on the prognosis of life-threatening diseases.