TY - JOUR
T1 - Protein A immunoadsorption: A novel and effective adjuvant treatment of severe pemphigus
AU - Schmidt, E.
AU - Klinker, E.
AU - Opitz, A.
AU - Herzog, S.
AU - Sitaru, C.
AU - Goebeler, M.
AU - Mansouri Taleghoni, B.
AU - Bröcker, E. B.
AU - Zillikens, Detlef
PY - 2003/6/1
Y1 - 2003/6/1
N2 - 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 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.
AB - 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 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.
UR - http://www.scopus.com/inward/record.url?scp=0038346449&partnerID=8YFLogxK
U2 - 10.1046/j.1365-2133.2003.05302.x
DO - 10.1046/j.1365-2133.2003.05302.x
M3 - Journal articles
C2 - 12828752
AN - SCOPUS:0038346449
SN - 0007-0963
VL - 148
SP - 1222
EP - 1229
JO - British Journal of Dermatology
JF - British Journal of Dermatology
IS - 6
ER -
