自己免疫性水疱症の治療

概要

論文の詳細を見る
Systemic glucocorticosteroids remain the mainstay of therapy of autoimmune bullous diseases such as pemphigus and pemphigoid. Most of these diseases are successfully treated by systemic glucocorticoteroids ; however, some show resistance to the systemic glucocorticosteroids therapy. Furthcrmore, the patients associated with diabetes mellitus and hypertension should not be treated by glucocorticosteroids. To decrease the incidence of side effects of glucocorticosteroids, immunosuppressive drugs including cyclophosphamide, azathioprine, methotrexate, and cyclosporine are usually given in combination with steroids. In some cases of bullous pemphigoid, the combination therapy of tetracycline and nicotinamide is effective. Furthermore. DDS is effective in some patients with linear IgA bullous dermatosis and IgA pemphigus. Reports have been made on the effeacy of high-dose intravenous immunoglobulins for pemphigus vulgaris, but the results are controversial. Clinical trials of apheresis showed reduction in titers of pathogenic autoantibodies in pemphigus and clinical improvement in otherwise therapy-resistant cases of pemphius. In mild form of pemphigus and pemphigoid, a potent topical glucocorticosteroid alone was effective. Finally, some inducing and exacerbating factors of autoimmune bullous diseases are described.
日本アフェレシス学会の論文
2000-10-31