[Post-mortem evaluation in endemic pemphigus foliaceus and pemphigus vulgaris]

Eighteen autopsies were performed in patients with pemphigus that died during treatment between 1961 and 1981. Eight of these patients had endemic pemphigus foliaceus and ten had pemphigus vulgaris. The pemphigus vulgaris patients were receiving only corticosteroids while some of those with pemphigus vulgaris also received immunosuppressors. Side effects from the medication were a major contributing factor in the death of 7 of the 8 pemphigus foliaceus patients and in 8 of the 10 cases of pemphigus vulgaris. The causa mortis to which the medication contributed to was strongyloidiasis in 4 patients, disseminated septicemia in 3 patients, bronchial pneumonia in 3 patients, miliary tuberculosis in 2 patients, massive gastrointestinal hemorrhage, pulmonary infarct and balantidiasis with strongyloidiasis in 1 patient each. The authors stress the need for careful investigation of strongyloidiasis and eradication by treatment not only when starting but also during therapy with large doses of corticosteroids and cytotoxic agents.