Tratamiento con rituximab del pénfigo vulgar refractario a terapia convencional

Abstract

Introduction: Pemphigus vulgaris is a blistering disease of chronic, autoimmune and potentially life-threatening nature. The treatment consists of suppressing the production of autoantibodies produced by B-lymphocytes. Rituximab, a monoclonal antibody directed against the CD20 antigen found in B-lymphocytes, is a drug that has shown efficacy in patients with refractory pemphigus vulgaris. We present the clinical case of a patient who, with little response to conventional treatments (corticoids and mycophenolate mofetil) and side effects to azathioprine was treated with a rituximab dose of 375 mg/m 2/weekly associated with prednisone for 4 weeks with good tolerance, decrease in antibody count and sustained response during a 16-month follow-up period. Conclusion: Treatment with rituximab has proved effective in the long term for pemphigus vulgaris. This treatment should be reserved for refractory patients since there is less use experience and has a significant risk of serious infectious complications