Monitering of Circulating Autoantibodies to Desmogleins in Patients with Pemphigus during Treatment with Double Filtration Plasmapheresis Is Useful

Abstract

In this report, we examined the circulating autoantibody titers to desmogleins during plasma exchange (PE) treatment of patients with pemphigus. Three patients with pemphigus vulgaris (PV), who were unresponsive to standard managements such as systemic steroid and immunosuppressive therapies, were enrolled in this study. As assessed by serial desmoglein enzyme-linked immunosorbent assays (Dsg ELISAs), their serum antibody titer for Dsgs 1 and 3 closely paralleled their disease activities which they were treated with double filtration plasmapheresis (DFPP). The DFPP treatment resulted in a successful reduction of the total steroid volume and improvement of clinical manifestations; however, two of three patients experienced some transient adverse effects. We discuss the usefulness of Dsg ELISA in monitering the complex clinical course of pemphigus during an intense treatment such as DFPP.