Interest of therapeutic plasmapheresis in a chronic hemodialysis patient with severe bullous pemphigoid

Author:

Ahmadpoor Pedram1,Beck Mathilde2,Michel Moise3,Pambrun Emilie1,Stoebner Pierre24,Moranne Olivier15ORCID

Affiliation:

1. Service Néphrologie dialyse Aphérèse Hôpital Universitaire de Nîmes, CHU Carémeau France

2. Service de Dermatologie Hôpital Universitaire de Nîmes France

3. Service d'Immunologie Hôpital Universitaire de Nîmes France

4. IDESP, Université de Montpellier France

5. IRCM, Université de Montpellier France

Abstract

AbstractBullous pemphigoid is the most common autoimmune blistering disease induced by autoantibodies against basement membrane anchoring proteins (anti‐BP‐180 and anti‐BP‐230). The disease generally appears after the age of 70 and is associated with a 23.5% 1‐year mortality, especially in diabetics, or in the presence of ischemic heart disease and high anti‐BP‐180. Treatment starts with topical steroids but some patients may require oral steroids and systemic immunosuppression. We, hereby, discuss a diabetic patient on chronic hemodialysis, with severely relapsed bullous pemphigoid under biotherapy with omalizumab, who was successfully treated with five sessions of double filtration plasmapheresis, thus avoiding the need for systemic steroids.

Publisher

Wiley

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