This case report highlights the efficacy of rituximab (RTX), a monoclonal antibody that targets B-lymphocytes, in the treatment of severe pemphigus vulgaris (PV) that was unresponsive to multiple conventional therapies. A 44-year-old female presented with mucocutaneous lesions that had been progressing for 12 months, with a Pemphigus Disease and Area Index (PDAI) total activity score of 66, indicating severe disease. The patient received two infusions of RTX two weeks apart, without complications. Complete remission of the lesions was observed after four months of follow-up. The successful outcome of this case report reinforces RTX as a first-line treatment option in severe PV cases, although its feasibility should still be considered. It is important to note that RTX treatment may have limitations due to its high cost, potential for immunosuppression, and relatively high relapse rate after treatment cessation. This case report provides insights into the potential use of RTX in the treatment of moderate to severe PV and emphasizes the need for further research to evaluate its efficacy, safety, and long-term outcomes.
Keywords: auto-imune diseases; biologic therapies; pemphigus in adults; pemphigus vulgaris; rituximab therapy.
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