We treated 2 intractable patients with pemphigoid by absorbent plasmapheresis using dextran sulfate conjugated cellulose columns with an automated regenerating unit. During a 2 week period, this plasmapheresis was performed 4 to 6 times for Cases 1 and 2, respectively. Clinical findings including skin eruptions were remarkably improved, and the titers of antibasement membrane zone antibodies were decreased after the treatment of 1.8 to 4.2 L of plasma. These results suggest that the absorbent column is effective for intractable pemphigoid.
We describe a case of bullous pemphigoid (BP) in a patient with chronic renal failure maintained on hemodialysis. We diagnosed BP by histopathological and immunofluorescence studies. The relationship between BP and chronic renal failure and/or hemodialysis is not clear, but we believe that immune disarrangement due to chronic renal failure and/or hemodialysis may have influenced the pathogenesis of BP in our case.
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