Successful treatment of refactory mucosal lesions of pemphigus vulgaris using intravenous gammaglobulin as adjuvant therapy.

Improvement of Intravenous Immunoglobulin Therapy for Bullous Pemphigoid by Adding Immunosuppressive Agents

“…This concept is supported by several case reports of IVIg being clinically effective for the treatment of blistering diseases when given with an immunosuppressive agent [15][16][17] and ineffective when such an agent was not used. 18,19 It is further supported by reports that months are required for IVIg to lower serum levels of pemphigus antibodies when administered without an immunosuppressive agent, 20 while the decline occurs in weeks if an immunosuppressive drug is used.…”

IVIg TREATMENT OF PEMPHIGUS: How it Works and How to Use it

“…We believe the same approach should improve the effectiveness of IVIg treatment, which like plasmapheresis, causes a rapid and profound decline in serum levels of pemphigus antibodies. Support for this suggestion comes from: a) case reports of IVIg therapy of pemphigus describe the procedure as clinically effective when a cytotoxic agent is given concurrently [19][20][21] and as ineffective when such an agent is not used [22,23]; b) our own studies where IVIg more rapidly controlled disease activity and lowered serum pemphigus antibody levels when given with an effective dose of cyclophosphamide or azathioprine than without; and c) reports that months are required for IVIg to lower serum levels of pemphigus antibodies when administered without a cytotoxic agent, while the decrease occurs in days to weeks if a cytotoxic drug is used.…”

Use of IGIV in the Treatment of Immune-Mediated Dermatologic Disorders

“…In pemphigus vulgaris, desmoglein 3 serves as a target antigen expressed on basal keratinocytes (Thivolet, 1994;Stanley, 1997). A number of clinical reports have demonstrated the successful use of IGIV therapy in pemphigus patients (Harman and Black, 1999;Messer et al, 1995;Bewly and Keefe, 1996;Weaver et al, 1996;Colonna et al, 1998;Engineer et al, 2000;Ahmed 2001a). Although not universal, the responses appeared rapidly with stabilization of the disease.…”