Life-threatening course of pemphigus vulgaris complicated by sepsis caused by azathioprine-induced bone marrow suppression, successfully managed with combination therapy

Authors

  • Martin Tichy,

    Corresponding author
    1. Department of Dermatology and Venereology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
    • Address correspondence and reprint requests to: Martin Tichy, MD, PhD, Head of Department of Dermatology and Venereology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, I. P. Pavlova 6, 775 20 Olomouc, Czech Republic, or email: tichy.martin.jun@fnol.cz.

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  • Jaroslav Urbanek,

    1. Department of Dermatology and Venereology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
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  • Jan Sternbersky,

    1. Department of Dermatology and Venereology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
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  • Dagmar Ditrichova,

    1. Department of Dermatology and Venereology, Faculty of Medicine and Dentistry, Palacky University and University Hospital, Olomouc, Czech Republic
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  • Jana Hercogova

    1. Department of Dermatovenereology, 2nd Faculty of Medicine, Charles University, Bulovka Hospital, Prague, Czech Republic
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Abstract

Severe forms of pemphigus vulgaris (PV) that are resistant to standard treatment present a life-threatening disease with a mortality of 5–10%. The treatment is usually individualized. The most popular procedures used today include intravenous applications of immunoglobulins and rituximab. Currently the common use of pulse corticosteroids, often in first-line treatment, is being neglected. This particular case documented the severity of the disease and also the need for combined and comprehensive care, in which corticosteroid pulse therapy still plays an important role.

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