Use of monoclonal anti-CD20 (rituximab) in a patient with severe pemphigus vulgaris.
Keywords:
pemphigus vulgaris, corticosteroids, monoclonal antibodies, immunosuppressive agents, B lymphocytesAbstract
Pemphigus vulgaris is an autoimmune blistering disease of skin and mucous membranes and has a chronic course. The immunopathogenesis is based on the presence of autoantibodies (IgG) produced by B cells and directed against the surface of keratinocytes, producing a loss of intercellular adhesion and the formation of subepidermal blisters. The morbidity and mortality is variable being very important the established treatment. Multiple immunosuppressive treatments have been used, particularly corticosteroids and multiple immunomodulatories, but in some refractory cases or in the presence of side effects of conventional immunosuppressive therapy is insufficient to control the disease and reduce morbidity and mortality.
We discuss the use of monoclonal anti-CD20 B cells (rituximab) for the management of refractory pemphigus vulgaris and with poor response to multiple conventional treatments at high doses and for prolonged periods of time.
Author Biographies
Carolina Concha
Médica residente, Servicio de Dermatología, Departamento de Medicina Interna, Escuela de Medicina, Facultad de Salud, Universidad del Valle, Cali, Colombia.
Lucy García
Médica dermatóloga, M.Sc. en Ciencias Básicas Médicas; profesora auxiliar, Servicio de Dermatología, Departamento de Medicina Interna, Escuela de Medicina, Facultad de Salud, Universidad del Valle, Cali, Colombia.
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