[Treatment of pemphigus with plasmapheresis]

Therapeutic plasmapheresis was successfully used in a 29-year-old man with corticosteroid-resistant pemphigus vulgaris who had severe side-effects from the medication. 4 plasmaphereses were performed over a period of 3 weeks with removal of a total of 7900 ml of plasma. Concurrently he received large doses of adrenal steroids and Imuran. There was clinical improvement soon after the first plasmapheresis and 8 weeks after the treatment was started he was free of lesions. IC-Ab titers markedly decreased during the course of treatment and continued to decrease after it was completed. Side-effects were few and relatively mild. Plasmapheresis may be a useful adjunct in the treatment of pemphigus vulgaris resistant to conventional therapy. It may be used initially together with corticosteroids, giving more rapid improvement, as well as a corticosteroid-sparing effect.