Azathioprine/prednisone withdrawal

Abstract

Progression of pemphigus vulgaris: case reportA 60-year-old man experienced progression of pemphigus vulgaris following dose tapering of azathioprine and prednisone during treatment of pemphigus vulgaris [routes not stated].The man, who had pemphigus vulgaris, was hospitalised for exacerbation of skin lesions. He started receiving azathioprine 1.5 mg/kg in August 2018, which tapered to 1 mg/kg by October 2018. He also started receiving prednisone 1 mg/kg, which was tapered to 0.5 mg/kg in August 2018 and further tapered to 0.4 mg/kg in March 2019. However, sudden progression of the disease was noted following the dose tapering of prednisone and azathioprine.The doses of azathioprine and prednisone were again increased to 1.5 mg/kg. Despite this, the man experienced further progression of disease. He was then treated with rituximab. Subsequently, a significant improvement was observed without side effects. At final follow-up, he was on prednisone 0.3 mg/kg and azathioprine 100 mg/day with further tapering.