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Novel treatment (new drug/intervention; established drug/procedure in new situation)
CASE REPORT
Facilitated subcutaneous immunoglobulin treatment in pemphigus vulgaris
  1. Massimo Radin1,
  2. Dario Roccatello1,2,
  3. Simone Baldovino1,2,
  4. Savino Sciascia1,2
  1. 1Department of Clinical and Biological Sciences, Center of Research of Immunopathology and Rare Diseases, Coordinating Center of Piemonte and Valle d’Aosta Network for Rare Diseases, S. Giovanni Bosco Hospital, Turin, Italy
  2. 2SCDU Nephrology and Dialysis, S. Giovanni Bosco Hospital and University of Turin, Turin Italy
  1. Correspondence to Dr Savino Sciascia, savino.sciascia{at}unito.it

Summary

A novel administration strategy of immunoglobulin treatment is represented by injection of recombinant human hyaluronidase (rHUPH20) with subcutaneous immunoglobulins. The use of facilitated subcutaneous immunoglobulin treatment (fSCIG) for the treatment of autoimmune conditions is yet to be investigated. We present the case of a 56-year-old female patient with pemphigus vulgaris predominantly of the oral mucous membranes, previously treated for 24 months with azathioprine and medium doses of steroids, with only partial remission. When she came to our attention, a concomitant newly diagnosed infiltrating ductal breast cancer limited the use of immunosuppressive agents. She was started with fSCIG (25 g/monthly). After 18 months of follow-up, her breast cancer has been successfully treated and a substantial decrease of the rate of bullous mucous lesions and improvement of time to lesion healing and resolution was observed. fSCIG might represent a steroid-sparing tool for the treatment of selected cases of pemphigus vulgaris.

  • immunology
  • dermatology
  • haematology (drugs and medicines)

https://doi.org/10.1136/bcr-2017-223302

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    Footnotes

    • Contributors MR drafted the manuscript, figures and tables. DR, SB and SS contributed to the writing of the manuscript and critically analysed the findings.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.