Successful treatment of a severe persistent case of pemphigoid gestationis with antepartum and postpartum intravenous immunoglobulin followed by azathioprine.
We report a case of pemphigoid gestationis affecting a 37-year-old woman in both her pregnancies. In her second pregnancy she failed to respond to high-dose oral prednisolone. She was treated successfully with intravenous immunoglobulin (2 g/kg each infusion cycle) as a steroid-sparing agent during both the antepartum and postpartum period. The baby was born at the 36th week of gestation. No complications were noted for either mother or baby. After ceasing intravenous immunoglobulin, azathioprine (up to a dose of 1 mg/kg/day) was used to adequately control her pemphigoid gestationis.
Department of Dermatology, St Vincent's Hospital, Victoria, Australia. drdesmondgan@gmail.com
Desmond Chia Chin
DC
Gan
Belinda
B
Welsh
Michael
M
Webster
D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D006559:Pemphigoid Gestationis / Q000188:drug therapy*; D011181:Postnatal Care; D011247:Pregnancy; D011295:Prenatal Care; D012720:Severity of Illness Index; D016896:Treatment Outcome
D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D007166:Immunosuppressive Agents; D001379:Azathioprine