Severe multi-resistant pemphigus vulgaris: prolonged remission with a single cycle of rituximab

• Published in: Anais brasileiros de dermatología Vol. 88; no. 4; pp. 639 - 642
• Main Authors: Corral, Isabela Soubhia, Freitas, Thais Helena Proença de, Aquino, Renata Telles Rudge de, Koller, Daniella Abbruzzini S, Magliari, Maria Elisa Ruffolo, Muller, Helena
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Dermatologia 01.08.2013
• Subjects: Adult; Antibodies, Monoclonal, Murine-Derived - administration & dosage; Case Report; DERMATOLOGY; Desmogleins; Drug resistance; Drug Resistance, Multiple; Glucocorticoids - administration & dosage; Humans; Immunologic Factors - administration & dosage; Male; Pemphigus; Pemphigus - drug therapy; Prednisone - administration & dosage; Rituximab; Time Factors; Treatment failure; Treatment Outcome; Pênfigo; Pemphigus; Falha de tratamento; Desmogleínas; Treatment failure; Drug resistance; Desmogleins; Resistência a medicamentos
• ISSN: 0365-0596; 1806-4841; 1806-4841; 0365-0596
• DOI: 10.1590/abd1806-4841.20131990

Pemphigus vulgaris is an autoimmune bullous disease whose therapy is based on systemic corticosteroids, with or without immunosuppressants. Rituximab is a chimeric monoclonal antibody of the IgG class, directed at a specific CD20 B cell surface antigen, used in pemphigus vulgaris empirically since 2002, with success in 90% of the cases and long periods of remission. Male patient, 33 years old, diagnosed with pemphigus vulgaris, confirmed by histopathology and direct immunofluorescence. He was treated for seven months with numerous treatments, including immunosuppressive drugs, with an unsatisfactory response, until he had complete remission with the use of rituximab. During a 34-month follow-up period, the patient presented a slight clinical relapse, which was successfully controlled with prednisone in a daily dose of 120 mg, soon reduced to 20mg.