Protein A immunoadsorption: a novel and effective adjuvant treatment of severe pemphigus.
Br J Dermatol
; 148(6): 1222-9, 2003 Jun.
Article
em En
| MEDLINE
| ID: mdl-12828752
ABSTRACT
BACKGROUND:
Pemphigus foliaceus (PF) and pemphigus vulgaris (PV) are autoimmune blistering skin diseases usually treated with high-dose systemic corticosteroids and other immunosuppressants that may cause severe side-effects. Plasmapheresis also has been demonstrated to be of benefit in the treatment of pemphigus. In contrast to plasmapheresis, staphylococcal protein A immunoadsorption (PA-IA) specifically removes immunoglobulin from the circulation, allows treatment of larger plasma volumes, and does not require the substitution of plasma components.OBJECTIVES:
To determine the effectiveness and side-effects of PA-IA in patients with severe pemphigus.METHODS:
Five patients with severe pemphigus (PV, n = 4; PF, n = 1) were treated by PA-IA. Three of these patients had been refractory to various treatment regimens. In addition to PA-IA, methylprednisolone, 0.5 mg x kg-1 body weight day-1 was given initially and subsequently tapered.RESULTS:
In all patients, a dramatic clinical improvement was seen within 2 weeks after initiation of therapy. Patients were free of lesions after 3, 4, 4, 10 and 21 weeks of treatment, respectively. Concurrently, autoantibody levels decreased rapidly.CONCLUSIONS:
PA-IA is a rational, effective, and safe adjuvant therapy for severe pemphigus and warrants wider use for this indication. A controlled study should compare side-effects and effectiveness of PA-IA with other treatment options for pemphigus.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Proteína Estafilocócica A
/
Pênfigo
Limite:
Adult
/
Aged
/
Child
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Br J Dermatol
Ano de publicação:
2003
Tipo de documento:
Article
País de afiliação:
Alemanha