Synchronization of plasmapheresis and pulse cyclophosphamide therapy in pemphigus vulgaris

Abstract

Background: Vesiculo-bullous diseases are a group of chronic cutaneous disorders characterised by mucocutaneous blistering or erosions as a result of development of autoimmunity. Aims: To understand the pathophysiology of pemphigus vulgaris and the recent concepts of Pulse therapy with different modalities and their various actions on different tissue levels. Results &Conclusion-Pulse therapy can be a boon to stomatologists if understood with clarity and applied with precision. It can definitely create miracles in saving lives and help in the outcome of the prognosis of most of the autoimmune disorders.

The Steroid‐Sparing Effect of Long‐Term Plasmapheresis in Pemphigus: An Update

“…Case reports and short-term open studies have shown that the best clinical results were obtained in steroid-resistant cases of pemphigus when PP was added to a previously ineffective therapeutic regimen (1 1,13,15). Optimal control of disease activity has been achieved with PP in association with both glucocorticosteroids and other immunosuppressive agents (14). In our study, 4 patients had prolonged disease activity resistant to conventional therapy with prednisone and different immunosuppressive agents.…”

“…However, the dosages are usually high, and so are complication rates (3-5). Plasmapheresis (PP) has been suggested as a steroid-sparing procedure in pemphigus (6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Only 2 controlled studies (16,17) have been completed, and they were both short-term investigations (maximum 4 weeks).…”

The role of therapeutic plasma exchange in pemphigus vulgaris

“…6,7 Since then, plasma exchange has been described as an effective adjuvant therapy in PV patients in controlling disease activity by reducing serum levels of autoantibodies. 4,[8][9][10][11][12][13][14][15][16] Turner et al 17 treated seven patients with severe or resistant pemphigus vulgaris with a series of five plasma exchanges over an average of 8 days with administration of immunosuppressive drugs immediately after plasmapheresis. Remission or partial remission was induced in six patients.…”

Synchronization of plasma exchange and cyclophosphamide in severe and refractory autoimmune hemolytic anemia

“…Synchronized therapy consisting of 3 days of PE followed by pulse and daily cyc/pred has been effective in the treatment of severe and resistant systemic lupus erythematosus (SLE) [ 1 4 1 as well as in reported cases of pemphigus vulgaris [5,6], Grave's ophthalmopathy [7], and Goodpasture's syndrome [S]. In this study we present two patients with severe and refractory autoimmune hemolytic anemia (AIHA) who responded to modified Schroeder and Euler [2] synchronized therapy.…”