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Treatment of Pemphigus Vulgaris with Protein A Immunoadsorption: Case Report of Long‐Term History Showing Favorable Outcome
Author(s) -
FROST NINA,
MESSER GERALD,
FIERLBECK GERHARD,
RISLER TEUT,
LYTTON SIMON D.
Publication year - 2005
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1196/annals.1361.103
Subject(s) - immunoadsorption , pemphigus vulgaris , outcome (game theory) , dermatology , term (time) , medicine , immunology , antibody , physics , mathematics , mathematical economics , quantum mechanics
A bstract : A pemphigus vulgaris (PV) patient with a 14‐year history of severe and painful blistering of skin and mucous membranes as well as side effects from corticosteroids and concomitant immunosuppressive drug treatment was managed successfully by protein A immunoadsorption (IA). After 19 sessions of protein A IA, the patient showed remission of PV and healing of mucocutaneous lesions and the skin. The level of the pathogenic autoantibodies to the adhesion proteins desmoglein 1 (Dsg‐1) and desmoglein 3 (Dsg‐3) measured by ELISA and immunofluorescence microscopy revealed a significant removal of autoantibodies after each IA therapy. There was a weak rebound of anti‐Dsg‐1 and anti‐Dsg‐3 antibodies between IA sessions but an overall decrease over the period of IA therapy. This case demonstrates the effective use of protein A IA as an adjuvant and corticosteroid‐sparing therapy in severe pemphigus refractory to standard immunosuppressive therapy and underscores the need for careful monitoring of autoantibodies.