Bullous pemphigoid associated with chronic renal allograft rejection

Peruzzo, Juliano; Dantas, Lia Dias Pinheiro; Zampese, Marcia Salete

doi:10.1016/j.jaad.2012.11.023

Cited by 13 publications

(14 citation statements)

References 5 publications

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“…Herein, we present a young patient with ESRD treated with haemodialysis who developed BP. To date, there are only six such cases published in the literature, including ours, three females and three males (details in Table ) . These patients were of different ages when they developed BP; two of them were younger than 52 years of age, and four were 72 years and older.…”

Section: Discussionmentioning

confidence: 84%

“…Within several months, it was possible to discontinue the therapy as he was in clinical remission for 6 months. Most of the similar patients in the literature were treated with prednisone alone or in combination with azathioprine and tetracycline , whereas two remaining patients achieved topical corticosteroids only (clobetasol, batametason) with success . On the basis of our experience in treating patients with provoked BP, we have noticed that most of them required mild therapies containing clobetasol or tetracycline as the first‐line treatment.…”

Section: Discussionmentioning

confidence: 89%

“…One patient developed BP a short time after the placement of the fistula for haemodialysis , whereas in five patients, BP occurred 1–11 years later . Most of the patients had coexisting hypertension; two had diabetes mellitus; one had anaemia , and another had prostrate cancer and stroke in the anamnesis . In only two of them, it was possible to characterise the BP180 BMZ antigen as a target for circulating antibodies using immunoblot or BIOCHIP (our patient), which consists of different antigen substrates, allowing polyvalent immunofluorescence tests, and provides antibody profiles in a single incubation.…”

Section: Discussionmentioning

confidence: 97%

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Development of bullous pemphigoid during the haemodialysis of a young man: case report and literature survey

Osipowicz

Kalińska-Bienias

Kowaléwski

et al. 2016

International Wound Journal

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Haemodialysis is the most frequent form of renal replacement therapy (RRT) in patients with end-stage renal disorder (ESRD). Patients with ESRD frequently develop skin problems, mainly xerosis, pruritus and hyperpigmentation, as well as bullous diseases, mainly porphyria or pseudoporphyria and, in some cases, bullous pemphigoid (BP). BP is the most common autoimmune sub-epidermal blistering disease, and it predominantly affects elderly people. Clinically, BP is characterised by generalised pruritic, bullous eruptions and urticaria-like lesions. Usually, BP is an idiopathic disorder; however, in some cases, underlying internal disorders are present, like diabetes or neurological disorders. Herein, we present a 33-year-old man with ESRD, maintained on haemodialysis, who developed BP. There are only six cases with BP provoked by the placement of a fistula for haemodialysis. BP in the current patient was confirmed by direct immunofluorescence (DIF) and indirect immunofluorescence using BIOCHIP. The patient responded promptly to tertracycline and 0·05% clobetasol propionate lesionally. However, the relationship between BP and the fistula for haemodialisys still remains unknown. It is highly likely that the skin injury associated with fistula placement was responsible for the alteration of the basement membrane zone (BMZ) and the stimulation of the immune system, leading to BP development. To explain the real role of fistula placement as a provocative factor in BP, other such cases are required for assessment.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 97%

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Development of bullous pemphigoid during the haemodialysis of a young man: case report and literature survey

Osipowicz

Kalińska-Bienias

Kowaléwski

et al. 2016

International Wound Journal

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“…Numerous case reports associating BP with renal transplant rejection have been published previously [29,30]. For most of them, BP occurred after the onset of rejection and was preceded by a dose decrease or a withdrawal of immunosuppressive drugs.…”

Section: Discussionmentioning

confidence: 99%

Predicting the onset of bullous pemphigoid with co-morbidities: A survey based on a nationwide medical database

Kuo

Yang

et al. 2013

2013 IEEE International Conference on Bioinformatics and Biomedicine

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Bullous pemphigoid (BP) is an acute or chronic autoimmune skin disease. It has been reported that poor conditions of general health and increased mortality rates were observed in BP patients, while pathophysiologic reasons of these phenomena merit further investigation yet. In this paper we tried to investigate the co-morbid associations between bullous pemphigoid and various diseases, using a nationwide population-based medical database, NHIRD. 5,933 adult BP patients of ages >= 18 years were extracted from the NHIRD, accompanied with 17,712 age-and sex-matched control subjects. Thirty-one disorders were selected from the Charlson or Elixhauser index for which we tried to evaluate their respective associations with BP. The results obtained revealed that there existed co-morbid relationships between BP and various illnesses, especially for hemiplegia/paraplegia (odds ratio [OR] 8.71), dementia (OR 8.04), fluid electrolyte disorders (OR 6.6), cerebrovascular disease (OR 5.97), moderate/severe liver disease (OR 5.22), weight loss (OR 4.9), and psychoses (OR 4.64). Furthermore, using the study cohort as input data and the retrospective diagnosis records of the abovementioned co-morbidities occurring within 24 months before onset of BP as features, we employed the algorithm of support vector machine (SVM) to generate the prediction model for onset of BP afterward. Subjects labeled as positive by the prediction model were about 9 times more likely than those as negative to actually develop BP. Accordingly, the prediction model created by SVM was valuable for physicians to screen patients with higher risk of BP.

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“…At the first dermatological visit she did not report any significant comorbidities or other drug intake. The occurrence of BP in association with renal transplantation is rare; only 11 such cases have been reported [5][6][7][8][9]. Topical and systemic steroids and antihistamines brought a partial clinical benefit, with recurrence at treatment discontinuation.…”

Section: Bullous Pemphigoid In a Renal Transplant Recipientmentioning

confidence: 99%