Management of Pemphigus Vulgaris in Pregnancy - Case Report

Abstract

Pemphigus vulgaris is a rare autoimmune bullous disease caused by producing autoantibodies directed against transmembrane glycoproteins of desmosomes that can lead to steric hindrance to homophilic adhesion of desmogleins. The development of pemphigus during the pregnancy is rare. The disruption of the Th1:Th2 balance in the autoimmune disease during the pregnancy plays a crucial role and explains why some studies have reported the exacerbation of disease, while others observe improvements during the pregnancy. We present aclinical case of a 31-year-oldprimigravida, with dichorionic - diamniotic twin pregnancyassociatedwith pemphigus vulgaris, being discovered 2 years ago, who went under treatment with Medrol 64mg/day and Imuran 50mg/day. She was admitted to the hospital at 31 weeks of gestation with non-systemic contractions of moderate intensity. The clinical findings are multiple erosions and blisters which have been accentuated during the second semester and have been remitted after delivery. Nowadays, the therapeutic management of the pemphigus during the pregnancy is not yet established and all of these cases are individual evaluated with the primary target to control the disease with the safety of the fetus.