Atypical pemphigus associated with monoclonal IgA gammopathy

Miyagawa, Sachiko; Hashimoto, Takashi; Ohno, Haruhiko; Nakagawa, Akemi; Watanabe, Kyoko; Nishikawa, Takeji; Shirai, Toshihiko

doi:10.1016/0190-9622(95)90402-6

Cited by 38 publications

(30 citation statements)

References 25 publications

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“…To the best of our knowledge, only 18 cases of IgG/IgA pemphigus have been reported thus far in the English literature 1-11 and were first described by Nishikawa et al, 12 in which they reported an atypical pemphigus foliaceus case. [3][4][5]8,[14][15][16][17] In our case, the patient had a history of endometrial cancer before the onset of IgG/IgA pemphigus, further supporting the possible association with malignancy. 13 Many authors have postulated that IgG/IgA pemphigus may be associated with malignancy, such as lung carcinoma, ovarian carcinoma, carcinoma of the gallbladder, and IgA gammopathy with a few previous cases reporting a paraneoplastic association.…”

Section: Discussionsupporting

confidence: 56%

IgG/IgA Pemphigus

Lane

Parekh²

2014

The American Journal of Dermatopathology

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IgG/IgA pemphigus has recently been described in the literature as an overlap of pemphigus vulgaris or pemphigus foliaceus with IgA pemphigus. There has also been some postulation that this IgG/IgA pemphigus may be associated with internal malignancy as well. Our case demonstrates the unique clinical, histopathological, and direct immunofluorescence findings of IgG/IgA pemphigus and further highlights the possibility of association of this disease with internal malignancy.

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Section: Discussionsupporting

confidence: 56%

IgG/IgA Pemphigus

Lane

Parekh²

2014

The American Journal of Dermatopathology

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“…In der Knochenmarkspunktion zeigte sich eine Vermehrung atypischer Plasmazellen; dennoch ergab sich kein sicherer Anhalt für ein Plasmozytom. Bei einigen Patienten mit dem SPD-Typ des IgA-Pemphigus wurde eine Assoziation mit einer monoklonalen IgA-Gammopathie beschrieben [3,17].Einige der Gammopathien waren benigne, andere standen im Zusammenhang mit einem B-ZellLymphom oder einem Myelom [22]. Das Auftreten einer monoklonalen IgAGammopathie wurde sowohl vor als auch nach Beginn der Hauterkrankung berichtet.…”

Section: Diagnostikunclassified

Intertriginöse Vesikel und Pusteln bei einem 36-Jährigen

et al. 2003

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Abb. 1a,b ▲ Pusteln, Erosionen und seröse Krusten auf gerötetem Grund; zusätzlich multiple postinflammatorisch hyperpigmentierte Maculae in der linken Axilla (a); Ausschnittsvergröße-rung (b) AnamneseBei einem 36-jährigen Patienten traten seit mehreren Jahren rezidivierend juckende Bläschen und Pusteln auf, die vor allem axillär,inguinal,am Rücken und den Oberarmen imponierten. Die Läsio-nen heilten unter Hypo-bzw. Hyperpigmentierungen ab. Die histologische Untersuchung einer Hautbiopsie zeigte eine subkorneale Pustel. Unter dem Verdacht einer subkornealen Pustulosis SneddonWilkinson wurde ein Therapieversuch mit Dapson eingeleitet (täglich 2 mg/kg Kör-pergewicht). Der Patient setzte diese Behandlung trotz Besserung des Hautbefundes wegen subjektiv empfundener Belastungsdyspnoe ab. In der Folgezeit wurde eine 12-monatige Therapie mit Azathioprin (Imurek®, täglich 2 mg/kg Körper-gewicht) und Prednison (Decortin®, 5 mg/d) durchgeführt, die jedoch keine Besserung bewirkte. Liebe Kolleginnen, liebe Kollegen

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“…The presence of IgA merits further study because it has frequently been related to pathogenesis, diagnosis (Zone & Meyer 1989;Miyagawa et al 1995), therapeutics (Kuechle et al 1994) and prognosis (Petersen et al 1986) in other dermatoses. The significantly predominant detection of IgG1 and IgG2 over IgG4, IgA and the lack of detection of IgE in the active lesion of LCL patients suggests a Th1 type immune response as has been demonstrated by measuring cytokine production by parasite antigen-stimulated peripheral blood mononuclear cells (PBMCs) (Caste Â s et al 1983;Carvalho et al 1985;Passwell et al 1987); and by serum isotype profile (Rodrõ Âguez et al 1996) in LCL patients.…”

Section: Discussionmentioning

confidence: 99%

Intralesional isotype profiles in human localized cutaneous leishmaniasis lesions

et al. 2001

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This immunocytochemical study evaluates the presence of IgG1-4, IgA and IgE immunoglobulins in active lesions of 25 localized cutaneous leishmaniasis patients from three bioclimatic areas (Awa, Afa and Bsha) in Mérida State, Venezuela. All immunoglobulin isotypes except IgE were detected, with variable intensity, in one or more of the epidermal or dermal components of skin lesions. IgG1 and IgG2 were detected significantly more frequently than IgG3, IgG4 and IgA. The ranking of the isotypes according to frequency of detection was the same in all areas: IgG1 = IgG2 > IgG3 = IgG4 = IgA, but considered as whole, all isotypes were detected significantly more frequently in patients from the Awa area than in those from the Bsha area. The predominant expression of isotypes IgG1 and IgG2 suggests a preferential Th1 like immune response. Anti-Leishmania immunoserum stained only parasites and their debris, suggesting that most of the immunostaining was nonspecific.

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Atypical pemphigus associated with monoclonal IgA gammopathy

Cited by 38 publications

References 25 publications

IgG/IgA Pemphigus

IgG/IgA Pemphigus

Intertriginöse Vesikel und Pusteln bei einem 36-Jährigen

Intralesional isotype profiles in human localized cutaneous leishmaniasis lesions

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