Plasma exchange in pemphigus. Uncontrolled study of ten patients

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Abstract
Plasma exchange, together with oral immunosuppressive drugs and various doses of adrenal steroids, were used in the treatment of 10 patients with pemphigus. Initially plasma exchange decreased the intercellular antibody (IC Ab) level in all patients and induced a clinical improvement in the conditions of 8 of 10 patients. This improvement was sustained for the 6 patients who received simultaneously 0.5 mg/kg per day or more of prednisone. Among the 8 patients, 4 previously corticoresistant patients had complete control of their disease. The other 4 patients, treated with low doses of prednisone, experienced a post-treatment rebound in IC Ab level and showed no or only transient clinical improvement. Plasma exchange may be useful in brining corticoresistant pemphigus under control but it is not to be used without accompanying high doses of adrenal steroids.