尋常性天疱瘡による口内炎の4症例とその免疫学的検討

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Three cases of pemphigus vulgaris with lesion confined to oral mucosa and one case manifesting stomatitis with mild dermatitis were treated. The diagnosis was based on the oral pathohistological picture and the circulating antipemphigus antibody (hereafter referred to as I.C. antibody). The patients were given adrenocortical hormone at the Department of Dermatology, and the relation between stomatitis and I.C. antibody was observed there in cooperation with our Department. Case 1, a female aged 49 with 40 fold LC. antibody titre, but 30 mg of Predonine mitigated the symptom, lowering the titre to 0. Case 2, a female aged 58 with I.C. antibody titre as high as 160 to 640 fold. Predonine administration in doses of 10 to 20 mg for about 18 months markedly improved the oral symptom, and the I.C. antibody titre level returned to normal Case 3, a female aged 34 with 160 fold I.C. antibody titre. Administration of 30 mg Predonine resulted in remission of the symptom, then the dose was reduced to 5 mg. In 4 months, the I.C. antibody titre reached 0, and the symptom almost vanished. Case 4, a male aged 80 with I.C. antibody titre as high as 640 fold. Oral administration of Predonine for 3 months brought about improvement of the oral symptom, the I.C. antibody titre falling to normal. As mentioned above, I.C. antibody titre, which was higher in the 4 cases during the development of the oral symptom, was restored to the normal level by administration of Predonine. It was consequently assumed that there might be an intimate relation between the oral symptom and I.C. antibody titre. Direct and indirect fluorescent antibody methods revealed the topical presence of IgG and C3 complement among epidermic cells in lesional oral mucosa.

尋常性天疱瘡による口内炎の4症例とその免疫学的検討

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