Treatment of Juvenile Pemphigus Vulgaris with Intravenous Immunoglobulin Therapy

• Published in: Pediatric dermatology Vol. 26; no. 2; pp. 197 - 202
• Main Authors: Asarch, Adam, Razzaque Ahmed, A.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.03.2009; Wiley
• Subjects: Adolescent; Biological and medical sciences; Bullous diseases of the skin; Dermatology; Female; Follow-Up Studies; Humans; Immunoglobulins, Intravenous - therapeutic use; Male; Medical sciences; Pemphigus - drug therapy; Treatment Outcome; Bullous dermatosis; Human; Immunopathology; Pediatrics; Skin disease; Treatment; Intravenous administration; Dermatology; Immunotherapy; Adolescent; Autoimmune disease; Pemphigus vulgaris
• ISSN: 0736-8046; 1525-1470
• DOI: 10.1111/j.1525-1470.2008.00808.x

:  We report the clinical response and follow‐up on eight patients with juvenile pemphigus vulgaris treated with intravenous immunoglobulin. Six Caucasian females and two Caucasian males ages 15 to 18 (mean 15.5) were treated with intravenous immunoglobulin based on a published protocol. The indications were lack of response and development of serious side‐effects to conventional therapy in four, lack of response to dapsone in two, and parental choice in two patients. In seven patients, a prolonged clinical remission was achieved. They received a mean of 28.5 cycles of intravenous immunoglobulin in a mean of 43.4 months and were followed for a mean of 29.8 months after discontinuing treatment. The remaining patient responded, but was lost to follow‐up. Mean follow‐up was 71.7 months. Six patients experienced mild headache, but no serious side‐effects were observed in any patient. Intravenous immunoglobulin is a safe biological agent to use in the treatment of juvenile pemphigus vulgaris. It can be used as monotherapy and has the potential to induce and sustain long‐term clinical remissions. In these eight patients, it appears that intravenous immunoglobulin is a safe biological agent without serious, immediate, or long‐term side effects. Intravenous immunoglobulin is a valuable agent in the treatment of certain cases of juvenile pemphigus vulgaris.