Case report: A novel high-dose intravenous immunoglobulin preparation for the treatment of severe pemphigus vulgaris failing standard therapy

J Dermatol. 2024 Dec;51(12):1665-1668. doi: 10.1111/1346-8138.17475. Epub 2024 Sep 30.

Abstract

Pemphigus vulgaris (PV) is a severe autoimmune bullous dermatosis that is characterized by autoantibodies against epidermal adhesion proteins causing painful mucosal and skin blistering. Standard treatments for PV include corticosteroids, steroid-sparing immunosuppressants, or intravenous monoclonal anti-CD20-antibody therapy. The European guidelines suggest high-dose intravenous immunoglobulin (IVIg) therapy as a promising approach for severe or treatment-resistant cases. We report on a 65-year-old woman with severe and recurrent disease who achieved long-term disease stabilization with IVIg treatment. Because of recurrent fatigue and headache, the patient was switched to an alternative IVIg preparation with a novel manufacturing process, thus ensuring high purity and better tolerability. We observed excellent efficacy, yet side effects remained largely unchanged. Further studies are necessary to evaluate the long-term efficacy and tolerability of this new IVIg preparation.

Keywords: IVIg; adverse effects; autoimmune bullous dermatoses; intravenous immunoglobulins; pemphigus vulgaris.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Drug Substitution
  • Female
  • Humans
  • Immunoglobulins, Intravenous* / administration & dosage
  • Immunoglobulins, Intravenous* / therapeutic use
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / therapeutic use
  • Pemphigus* / drug therapy
  • Pemphigus* / immunology
  • Recurrence
  • Severity of Illness Index
  • Treatment Failure
  • Treatment Outcome

Substances

  • Immunoglobulins, Intravenous
  • Immunologic Factors