Successful immunoapheresis of bullous autoimmune diseases: pemphigus vulgaris and pemphigoid gestationis

Marker, Michael; Derfler, Kurt; Itzinger-Monshi, Babak; Rappersberger, Klemens

doi:10.1111/j.1610-0387.2010.07500.x

Cited by 23 publications

(21 citation statements)

References 15 publications

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“…Plasmapheresis or plasma exchange is used to remove immunoglobulins and immune complexes from the circulation and can be efficacious in the setting of autoantibody‐mediated disease. It is used for severe autoimmune bullous disease and safe use was reported once in a 30‐year‐old woman with severe pemphigoid gestationis .…”

Section: Plasma Exchange/plasmapheresismentioning

confidence: 99%

Treatment of dermatologic connective tissue disease and autoimmune blistering disorders in pregnancy

Braunstein

Werth

2013

Dermatol Ther

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Autoimmune skin disease occurs in pregnancy, and treatment is often required to control both maternal disease and fetal outcomes. Here we present the available safety data in pregnancy and lactation for medications used to treat autoimmune skin diseases, including cutaneous lupus erythematosus, dermatomyositis, morphea and systemic sclerosis, pemphigus vulgaris, pemphigus foliaceus, and pemphigoid gestationis. A PubMed search of the English-language literature using keywords, "pregnancy" "rheumatic disease," and "connective tissue disease" was performed. Relevant articles found in the search and references were included. Reasonable evidence supports the careful and cautious use of topical steroids, topical calcineurin inhibitors, systemic corticosteroids, hydroxychloroquine, and azathioprine in pregnancy. Case reports or clinical experience suggest intravenous immunoglobulin, dapsone, phototherapy, rituximab, and plasmapheresis may be safe. Several treatment options exist for autoimmune skin disease in pregnancy and lactation, and should be considered when treating these patients.

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Section: Plasma Exchange/plasmapheresismentioning

confidence: 99%

Treatment of dermatologic connective tissue disease and autoimmune blistering disorders in pregnancy

Braunstein

Werth

2013

Dermatol Ther

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“…[7][8][9] These features are almost the same as those of bullous pemphigoid (BP), indicating that PG is BP during pregnancy. 10 It is unknown why PG occurs in young, pregnant women, while BP preferentially affects older people of both sexes; however, there are several clues: cross-reactivity at the basement membrane zone (BMZ) in skin, chorionic villi and amnion; production of BP180 in placenta; [11][12][13] and specific major histocompatibility complex molecules found in patients and their partners. 14 Thus, PG may develop through the production of autoantibodies to excessive BP180 in placenta under the specific genetic predisposition of couples.…”

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confidence: 99%

Clinical and immunological profiles of 25 patients with pemphigoid gestationis

et al. 2014

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“…Plazmaferez ve immünadsorpsiyon, Goodpasture sendromu, myastenia gravis ve romatoid artrit gibi antikor aracılı hastalıkların tedavisinde kullanılmaktadır. Plazmaferez pemfigus vulgariste ilk kez 1978 yılında, immünadsorbsiyon ise PNP 1998 yılında kullanılmıştır 8 ; PF, büllöz pemfigoid 9 , pemfigoid gestasyones 10,11 , anti p-200 pemfigoidi 12 ve akiz epidermolizis bülloza 13 tedavisinde de kullanıldığına ilişkin yayınlar mevcuttur. Literatürde PV'de plazmaferez kullanımına dair mevcut olan tek kontrollü çalışma Guillaume ve ark.…”

Section: Discussionunclassified

Plasmapheresis/immunoadsorption in patients with pemphigus

Küçükoğlu¹,

Erdem²,

Beşışık³

2015

TURKDERM

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Background and Design: Plasmapheresis and immunoadsorption, which is a more advanced method, are among the treatment options that induce a rapid remission in severe and resistant pemphigus. The aim of this study was to evaluate the efficacy and safety of plasmapheresis and immunoadsorption therapies via the clinical experience gained from our patients with pemphigus vulgaris (PV) and paraneoplastic pemphigus (PNP). Materials and Methods: Among patients who were diagnosed with pemphigus according to the histopathology and/or immunofluorescence methods and followed-up at our bullous diseases outpatient clinic between the years 1987 and 2013, 7 patients (5 PV, 2 PNP), who were treated with plasmapheresis or immunoadsorption, were retrospectively analyzed. Among these patients, 3 were treated with classical plasmapheresis, whereas 2 with double-filtration plasmapheresis, 1 with immunoadsorption, and 1 initially with classical plasmapheresis followed by immunoadsorption due to impairment of the hemodynamic parameters. The clinical findings, antibody titers, and immunological responses before and after the therapy, the therapy dosages and adverse effects were evaluated according to the data gained from the patient files. Results: In 4 patients (1., 3., 4. and 5. patients) with pemphigus vulgaris, complete clinical response was achieved, while 1 patient (2. patient) showed partial regression in skin lesions. In two patients (6., 7. patients) with paraneoplastic pemphigus, the therapy discontinued due to complications. In all of the evaluated patients, the analysis of the antibody titers before and after the therapy revealed lower levels in

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Successful immunoapheresis of bullous autoimmune diseases: pemphigus vulgaris and pemphigoid gestationis

Abstract: Immunoapheresis might represent an excellent therapy for certain patients with severe pemphigus vulgaris or pemphigoid gestationis, unresponsive to conventional treatment regimens. We observed rapid improvement of clinical symptoms and no notable side effects.

Cited by 23 publications

References 15 publications

Treatment of dermatologic connective tissue disease and autoimmune blistering disorders in pregnancy

Treatment of dermatologic connective tissue disease and autoimmune blistering disorders in pregnancy

Clinical and immunological profiles of 25 patients with pemphigoid gestationis

Plasmapheresis/immunoadsorption in patients with pemphigus

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