Utilisation of plasma exchange in the treatment of digital infarcts in Wegener's granulomatosis.

Digital ischemia is a rare manifestation of Wegener's granulomatosis (WG) with previous management approaches based on the hypotheses of thromboembolic phenomenon and vasospasm. WG is an autoimmune, antineutrophil cytoplasmic antibody-predominant small-to-medium-vessel necrotising vasculitis which mainly affects the pulmonary-renal system. We report on a patient with WG presenting with digital infarction. We successfully treated this patient who had digital infarcts refractory to cyclophosphamide, steroids and vasodilator agents, with plasma exchange.