Positive clinical outcome with IVIg as monotherapy in recurrent pemphigoid gestationis

Pemphigoid gestationis (PG) is an autoimmune blistering disease associated with pregnancy. It is characterized by the presence of autoantibodies against bullous pemphigoid antigens in the basement membrane zone. A 32year old female developed PG in the first pregnancy and had a stillbirth. PG recurre...

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Bibliographic Details
Published in:International immunopharmacology 2015-05, Vol.26 (1), p.1-3
Main Authors: Nguyen, Tegan, Alraqum, Esraa, Razzaque Ahmed, A.
Format: Article
Language:English
Subjects:
Adult
Autoimmune disease
Drug Administration Schedule
Female
Humans
Immunoglobulins, Intravenous - administration & dosage
Immunoglobulins, Intravenous - adverse effects
Immunoglobulins, Intravenous - therapeutic use
Immunologic Factors - administration & dosage
Immunologic Factors - adverse effects
Immunologic Factors - therapeutic use
Intravenous immunoglobulin
Pemphigoid gestationis
Pemphigoid Gestationis - drug therapy
Pemphigoid Gestationis - immunology
Pregnancy
Pregnancy Outcome
Recurrence
Treatment Outcome
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Summary:Pemphigoid gestationis (PG) is an autoimmune blistering disease associated with pregnancy. It is characterized by the presence of autoantibodies against bullous pemphigoid antigens in the basement membrane zone. A 32year old female developed PG in the first pregnancy and had a stillbirth. PG recurred during the second trimester of her second pregnancy. Systemic corticosteroid therapy was cause for concern since patient developed gestational diabetes. Patient was unwilling to use insulin. Intravenous immunoglobulin (IVIg) was used as a treatment of last resort. The dose was 2g/kg/cycle. It was given every two weeks antepartum and every three weeks for three months postpartum. PG improved within four weeks of IVIg therapy. Serum and tissue immunopathological studies were negative prior to delivery. A healthy neonate was born. No adverse events to IVIg were observed. No disease was observed ten months postpartum. •Pemphigoid gestationis is an autoimmune blistering disease associated with pregnancy.•Systemic corticosteroids are considered the mainstay of therapy.•IVIg has been used in few cases with variable results.•IVIg used as monotherapy produced excellent results.•IVIg as monotherapy may be of clinical benefit in refractory or recurrent PG.
ISSN:1567-5769
1878-1705
DOI:10.1016/j.intimp.2015.02.038