Membrane therapeutic plasma exchange (mTPE) is widely used in Japan, and central venous catheters are usually used for vascular access. However, central venous access devices can increase the patient burden and sometimes cause catheter infection. We report two cases of pemphigus vulgaris treated with centrifuge therapeutic plasma exchange (cTPE) through peripheral venous access; both were successfully treated without catheter infection. We also compared the efficacies of cTPE with eight patients treated with mTPE in our department in the last five years. cTPE resulted in non-inferior IgG reduction ratios and comparable therapeutic efficacy compared to those of mTPE. cTPE, which can be performed through peripheral venous access, is a good therapeutic option for plasma exchange.
We herein report six cases of bullous pemphigoid that developed after treatment with immune checkpoint inhibitors. Five patients had anti-BP180NC16a antibodies, and one had anti-LAD antibodies. The primary diseases in one case each were malignant melanoma and gastric cancer and renal cell carcinoma and lung cancer in two cases each. The median time from the start of immune checkpoint inhibitor treatment to bullous pemphigoid onset was 72 weeks (38-158 weeks). All but one patient had good responses to immune checkpoint inhibitors for the primary disease; five patients maintainied long-term progression-free survival.