Abstract
cyclophosphamide pulses. He developed solitary ileal perforation requiring surgery with ileostomy on follow up. Despite being on monthly CYC pulses for four months, along with steroids, he developed new vasculitic skin lesions along with new onset upper and lower limb peripheral neuropathy. He was given methylprednisolone pulses for three days along with hiking up of cyclophosphamide to biweekly with a plan to increase the interval to three weeks. He did not tolerate first session of plasmapheresis. Thecasehighlights the therapeutic challengeand lackof consensus guidelines in management of such cases of relapsing PAN.
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