A Case of pemphigus Vulgaris Expired by Acute Renal Failure

Yon, Han Dong; Sim, Woo Young

Abstract

Pemphigus is a rare, blistering autoimmune disease in which the action of antibodies is now well established. The most effective therapy is the administration of cortioseroids. Prior to the use of steroids, it was commonly fatal. Since the availability of corticosteroidsnortality has been markedly reduced. However prolonged administration of steroids may be difficult to sustain because of severe side effects. For these, other sdjuvant therapies were considered. Such as immunosuppresive drugs, gold, dapsone, plasmapheresis and intralesional injection of corticosteroid. Of these, immunosuppressive therapies are most commonly used. Recently cyclosporine which was for human organ transplantation is used in dermatology. Cyclosporine is a potent immunosupprc save agent with no appreciable effect on bone marrow and a selective inhibition to helper T cells. In our case, cyclosporine was administrated to the patient who had suffered from severe pemphigis vulgaris for 3 years without responding to treatment. We gave cyclosporine 400mg and prednisolon, 90mg per day. But we found a sudden increase of the RUN/Cr level and a shut down of the renal funtion. Therefore we discontinued cyclosporine and treated acute renal failure. However the renal damag e was irreversible and two days later the patient died.