title: Delayed response of oral pemphigus vulgaris to rituximab treatment.
abstract: Rituximab is a monoclonal antibody directed against the CD20 antigen of B cells, which has been developed for the treatment of lymphomas and has been successfully used in the treatment of recalcitrant pemphigus vulgaris. Here, we report on a 26-year-old patient with an 18 month history of pemphigus vulgaris of the oral mucosa where treatment with rituximab led to a delayed but sustained therapeutic response. This case is of interest since most of the previous reports have described a more rapid clinical improvement of refractory pemphigus by rituximab treatment. The delayed clinical response to rituximab of the present case may be explained by the persistence of long-lived plasma cells that continued to produce pathogenic autoantibodies against desmoglein 3.
authors.affiliation: Universitätsklinikum Giessen und Marburg, Klinik für Dermatologie und Allergologie, Standort Marburg. Andrea.Niedermeier@med.uni-marburg.de
authors.forename: Andrea
authors.initials: A
authors.lastname: Niedermeier
authors.forename: Petra
authors.initials: P
authors.lastname: Wörl
authors.forename: Sandra
authors.initials: S
authors.lastname: Barth
authors.forename: Gerold
authors.initials: G
authors.lastname: Schuler
authors.forename: Michael
authors.initials: M
authors.lastname: Hertl
mesh_terms: D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000188:drug therapy*; D010392:Pemphigus / Q000188:drug therapy*; D000069283:Rituximab; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab