Ghiasi Maryam; Daneshpazhooh Maryam; Balighi Kamran; Ghiasi Fatemeh
Volume 20, Issue 1 , 2017, , Pages 6-10
Abstract
Background: Intravenous immunoglobulin (IVIG) is used to treat many autoimmune and immunodeficiency disorders. The main indications of IVIG in dermatology include treatment for resistant autoimmune bullous diseases, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Although generally ...
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Background: Intravenous immunoglobulin (IVIG) is used to treat many autoimmune and immunodeficiency disorders. The main indications of IVIG in dermatology include treatment for resistant autoimmune bullous diseases, Stevens-Johnson syndrome (SJS), and toxic epidermal necrolysis (TEN). Although generally welltolerated, various adverse effects can occur.Methods: We designed a retrospective study to investigate the adverse effects of IVIG in all patients who received this drug in Razi Hospital from 2005-2016. Information was gathered from patients’ medical records.Results: During the study period, 67 patients received 94 IVIG infusions. The most common underlying dermatologic disease was pemphigus vulgaris (54 patients). The most frequent adverse effect of IVIG therapy was an increase in blood pressure for 17 patients and in 21 infusions of IVIG. Other adverse reactions included fatigue and generalized weakness, fever, chills, tachycardia, dizziness, a decrease in blood pressure, headache, flushing, chest discomfort, hemolysis, leukopenia, and deep vein thrombosis.Conclusions: Adverse events associated with IVIG therapy are usually mild and self-limiting. The incidence of serious adverse events is low. Identification of risk factors and close monitoring of high risk patients are essential to decrease the occurrence of serious adverse events.
Ghandi Narges; Tavassoli Shaghayegh; Ghiasi Maryam; Lajevardi Vahideh; Abedini Robabeh; Tohidinik Hamid-Reza; Daneshpazhooh Maryam
Volume 19, Issue 75 , 2016, , Pages 35-13
Abstract
Background: Prolactin (PRL) appears to play a role in the pathogenesis of autoimmune diseases. Limited evidence showed an association between serum PRL levels and the activity of pemphigus vulgaris (PV). This study intends to determine PRL level changes in pemphigus patients during therapy and its correlation ...
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Background: Prolactin (PRL) appears to play a role in the pathogenesis of autoimmune diseases. Limited evidence showed an association between serum PRL levels and the activity of pemphigus vulgaris (PV). This study intends to determine PRL level changes in pemphigus patients during therapy and its correlation with disease type and severity. Methods: In this cohort study, we measured serum PRL levels by enzyme-linked immunosorbent assay (ELISA) in newly diagnosed PV patients at three time points: before therapy initiation and after two and four months. Concomitantly, we estimated disease severity by the Pemphigus Disease Area Index (PDAI). Results: We examined 42 new cases of PV. Among 32 cases who completed the study, mean serum PRL levels at the three time points were 15.9±14.1 ng/mL (before treatment), 16.7±9.8 ng/ mL (2 months after initiation of treatment), and 15.2±9.2 ng/mL (4 months after initiation of treatment). Mean PDAI values were 19.3±12.8 (before treatment), 3.7±6.2 (2 months after initiation of treatment), and 0.6±1.5 (4 months after initiation of treatment). Although the disease activity decreased significantly (P
Esmaili Nafiseh; Chams-Davatchi Cheyda; Daneshpazhooh Maryam; Ghiasi Maryam; Abedini Robabe; Mortazavi Hossein; Roghani Iman
Volume 15, Issue 2 , 2012, , Pages 33-37
Abstract
Background: Pemphigus vulgaris (PV) is an autoimmune bullous disorder that is fatal if left untreated. High dose systemic corticosteroids are the basis of therapy. The addition of immunosuppressive agents has improved the disease outcome and reduced the required corticosteroid dose and related toxicity. ...
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Background: Pemphigus vulgaris (PV) is an autoimmune bullous disorder that is fatal if left untreated. High dose systemic corticosteroids are the basis of therapy. The addition of immunosuppressive agents has improved the disease outcome and reduced the required corticosteroid dose and related toxicity. Mycophenolate mofetil is increasingly used as a steroid-sparing agent in immunotherapy of PV. Herein, we tried to appraise the efficacy of mycophenolate mofetil and topical clobetasol in the control of the major relapses of pemphigus vulgaris. Method: Seventeen patients with severe relapse of pemphigus vulgaris were included in this study. All patients had complete remission on/off therapy before this period of recurrence. The patients were treated with 2g/day mycophenolate mofetil and 25-35g/day topical clobetasol propionate ointment. All patients were monitored for the side effects of therapy. Result: The patients were followed for a mean period of 12.7 months. The average length of time from initiating mycophenolate to 50% control (partial remission), which occurred in all patients, was 6±1.17 weeks. Fifteen patients achieved complete remission averagely at week 20.8±7.70. The average duration of followup after complete disease control was 8 months (ranging from 2-13.5 months). Three patients were free of lesions for more than 12 months and 10 for more than 6 months. No important mycophenolate mofetil related complication was observed during treatment. Conclusion: The combination of mycophenolate mofetil and topical corticosteroid can be used to control PV relapses and taper-off corticosteroid.
Nazemi-Tabrizi Mohammad-Javad; Hatami Parvaneh; Ghiasi Maryam; Daneshpazhooh Maryam; Chams-Davatchi Cheyda
Volume 15, Issue 2 , 2012, , Pages 42-46
Abstract
Background: Pemphigus vulgaris is a rare autoimmune disorder characterized by cutaneous and mucosal blistering. Surprisingly, the management of oral lesions has been detailed only infrequently. As current topical therapies for oral lesions are of limited efficacy, application of calcineurin inhibitors ...
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Background: Pemphigus vulgaris is a rare autoimmune disorder characterized by cutaneous and mucosal blistering. Surprisingly, the management of oral lesions has been detailed only infrequently. As current topical therapies for oral lesions are of limited efficacy, application of calcineurin inhibitors is considered to be a potential option. The aim of this essay was to investigate the efficacy of tacrolimus 0.1% ointment (Protopic®) versus triamcinolone acetonide 0.1% paste (Volon-A®) in the treatment of oral pemphigus vulgaris. Method: Fifteen patients were involved in a prospective randomized trial with a split- mouth design. After two weeks of administering study drugs, oral lesions were monitored and quantified pain and mucosal surface involvement scores were obtained. Result: Within 14 days, the degree of involvement and pain scores significantly reduced in both tacrolimus-treated and triamcinolone-treated sites, but there was no significant difference between them. No severe adverse events were observed. Conclusion: This study showed that tacrolimus could be as effective as triamcinolone acetonide in the topical treatment of oral pemphigus vulgaris.
