title: A case of herpetiform pemphigus associated with autoimmune hemolytic anemia: detection of autoantibodies against multiple epidermal antigens.
abstract: We report a case who was clinically and histopathologically diagnosed as herpetiform pemphigus (HP) and associated with autoimmune hemolytic anemia (AIHA). However, immunofluorescence studies demonstrated concurrent anti-cell-surface and anti-basement-membrane-zone antibodies in the patient's serum. Immunochemical studies showed that the patient's serum reacted with both the pemphigus foliaceus antigen and the two bullous pemphigoid antigens. Subsequently, the patient developed AIHA. Both anemia and skin lesions were successfully treated with oral prednisolone. We believe that this is the first case with HP in association with AIHA. The presence of autoantibodies against multiple antigens suggests an abnormal immunologic tolerance in the antibody production system in this patient.
authors.affiliation: Department of Dermatology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Shimizu
authors.forename: T
authors.initials: T
authors.lastname: Hashimoto
authors.forename: N
authors.initials: N
authors.lastname: Wang
authors.forename: K
authors.initials: K
authors.lastname: Watanabe
authors.forename: Y
authors.initials: Y
authors.lastname: Ohata
authors.forename: A
authors.initials: A
authors.lastname: Kikuchi
authors.forename: M
authors.initials: M
authors.lastname: Amagai
authors.forename: T
authors.initials: T
authors.lastname: Nishikawa
mesh_terms: D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications* / Q000276:immunology / Q000473:pathology; D001323:Autoantibodies / Q000032:analysis*; D003874:Dermatitis Herpetiformis / Q000150:complications* / Q000276:immunology / Q000473:pathology; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D008875:Middle Aged; D010392:Pemphigus / Q000150:complications* / Q000276:immunology / Q000473:pathology
chemical_list: D001323:Autoantibodies