Protein A immunoadsorption: A novel and effective adjuvant treatment of severe pemphigus

E. Schmidt, E. Klinker, A. Opitz, S. Herzog, C. Sitaru, M. Goebeler, B. Mansouri Taleghoni, E. B. Bröcker, Detlef Zillikens*

*Corresponding author for this work
88 Citations (Scopus)


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.

Original languageEnglish
JournalBritish Journal of Dermatology
Issue number6
Pages (from-to)1222-1229
Number of pages8
Publication statusPublished - 01.06.2003

Research Areas and Centers

  • Academic Focus: Center for Infection and Inflammation Research (ZIEL)


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