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J Eur Acad Dermatol Venereol. 2011 Jan;25(1):82-6. doi: 10.1111/j.1468-3083.2010.03703.x.

The role of therapeutic plasma exchange in pemphigus vulgaris.

Author information

1
Department of Dermatology, Sheba Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. lior115@gmail.com

Abstract

BACKGROUND:

The treatment of pemphigus, an autoimmune bullous disease, is based on the combination of corticosteroids and adjuvant therapies, such as immunosuppressive drugs, anti-inflammatory drugs and immunomodulatory procedures, such as intravenous immunoglobulin and therapeutic plasma exchange (TPE).

OBJECTIVE:

This study aims to assess our experience with TPE as a steroid-sparing modality in moderate and severe intractable pemphigus patients.

METHODS:

A retrospective evaluation for all intractable pemphigus patients treated by TPE in a university-affiliated tertiary referral medical centre between the years 1998 and 2008. Treatment protocol included three TPE treatments weekly for 1-3 months, combined with monthly pulse therapy of dexamethasone and/or cyclophosphamide. Maintenance therapy was based on once/bi weekly TPE treatments or monthly intravenous immunoglobulin.

RESULTS:

Seven patients were included in the study, four with severe pemphigus vulgaris and three with moderate disease. Six of the seven patients responded to TPE: Four patients (57%) achieved complete remission and two patients (28%) achieved partial remission on minimal therapy. Mild adverse effects related to TPE were observed in two patients and included dizziness and mild headache.

CONCLUSION:

TPE is a well-tolerated effective steroid-sparing agent in recalcitrant pemphigus patients.

[Indexed for MEDLINE]

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