Ocular autoimmune pemphigoid and cyclosporin A.
BACKGROUND
Ocular pemphigoid is a chronic autoimmune disease that leads to vision lost. In its etiology participate autoantibodies against the connective tissue of the conjunctiva of different isotypes (IgM, IgG and IgA) as well as the complement system (C3). Lymphocytes of the CD4 + and CD8 + phenotypes and monocytes were detected in the infiltrates of the biopsies of the conjunctiva.


METHODS
We treated and studied 82 patients who had several topical and systemic treatments during years to alleviate this condition but whose side effects limited their usefulness. We started the administration of cyclosporin-A (Cy-A) 100 mg/day per os and diminishing gradually the intake of steroids. The relief of ocular pain and headache were the first symptoms that changed the patients' quality of life. Ophtalmological controls revealed improvement of the lesions of the conjunctiva and cornea and subsequent biopsies showed a marked decrease in the cellular infiltrates and in antibody deposits.


CONCLUSIONS
Thus, Cy-A is an useful treatment for ocular chronic autoimmune pemphigoid and eventually azathioprine (50 mg/day) can cheaply replace it although its well-known toxicity.
Alonso
A
A
Centro de Alergia, Hospital de Clínicas and Hospital Oftalmológico Santa Lucía, Buenos Aires, Argentina. alehclin@fmed.uba.arg
Bignone
M L
ML
Brunzini
M
M
Brunzini
R
R
D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000276:immunology; D001379:Azathioprine / Q000191:economics / Q000627:therapeutic use; D003231:Conjunctivitis / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology; D003320:Corneal Ulcer / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology; D016572:Cyclosporine / Q000191:economics / Q000627:therapeutic use*; D016207:Cytokines / Q000276:immunology; D016527:Drug Costs; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000191:economics / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010391:Pemphigoid, Bullous / Q000188:drug therapy* / Q000276:immunology; D012189:Retrospective Studies; D016176:T-Lymphocyte Subsets / Q000187:drug effects / Q000276:immunology; D016896:Treatment Outcome
D016207:Cytokines; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D001379:Azathioprine