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Published on: January 26, 2024
Pemphigus, pregnancy, and plasmapheresis
Sherry Shieh1, Yisheng V Fang, Joanne L Becker
1State University of New York at Buffalo, USA.
Insights
Pemphigus vulgaris (PV) in pregnancy requires careful management. This case study shows successful treatment with corticosteroids and plasmapheresis, offering a safe alternative for pregnant patients.
Area of Science:
- Dermatology
- Immunology
- Obstetrics
Background:
- Pemphigus vulgaris (PV) is a rare autoimmune blistering disease affecting desmosomal proteins.
- It can occur during pregnancy, posing risks to both mother and fetus, including neonatal pemphigus (NP).
Observation:
- A pregnant woman presented with severe, widespread mucocutaneous blistering consistent with PV.
- Her condition worsened despite initial management.
Findings:
- Successful treatment was achieved using a combination of systemic corticosteroids and plasmapheresis.
- Plasmapheresis effectively removed pathogenic antibodies without significant immunosuppression.
Implications:
- PV should be considered in pregnant women with unexplained blistering disorders.
- Plasmapheresis is a viable and potentially safer therapeutic option than traditional immunosuppressants during pregnancy.
Abstract:
Pemphigus vulgaris (PV) is an autoimmune blistering disorder that usually occurs in the fifth and sixth decades of life but may occur at younger ages and during pregnancy. Circulating intercellular antibodies directed at desmosomal proteins may cross the placenta and place children at risk for neonatal pemphigus (NP). We describe the case of a pregnant woman with PV treated successfully with a combination of systemic corticosteroids and plasmapheresis. The possibility of PV should be considered in any pregnant woman with a worsening, widespread, mucocutaneous, blistering disease. Plasmapheresis offers a useful alternative to immunosuppressive therapy in the setting of pregnancy.
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