Friedman-Birnbaum R, Schechter Y, Bochner H
Dept. of Dermatology, Rambam Medical Center, Haifa.
Harefuah. 1989 Sep;117(5-6):135-7.
Therapeutic plasmapheresis was successfully used in a 29-year-old man with corticosteroid-resistant pemphigus vulgaris who had severe side-effects from the medication. 4 plasmaphereses were performed over a period of 3 weeks with removal of a total of 7900 ml of plasma. Concurrently he received large doses of adrenal steroids and Imuran. There was clinical improvement soon after the first plasmapheresis and 8 weeks after the treatment was started he was free of lesions. IC-Ab titers markedly decreased during the course of treatment and continued to decrease after it was completed. Side-effects were few and relatively mild. Plasmapheresis may be a useful adjunct in the treatment of pemphigus vulgaris resistant to conventional therapy. It may be used initially together with corticosteroids, giving more rapid improvement, as well as a corticosteroid-sparing effect.
治疗性血浆置换成功应用于一名29岁对皮质类固醇耐药的寻常型天疱疮男性患者，该患者因药物治疗出现严重副作用。在3周内进行了4次血浆置换，共去除7900毫升血浆。同时，他接受了大剂量肾上腺皮质类固醇和硫唑嘌呤治疗。首次血浆置换后不久临床症状即有改善，治疗开始8周后他的皮损消失。治疗过程中IC-Ab滴度显著下降，治疗结束后继续下降。副作用较少且相对较轻。血浆置换可能是治疗对传统疗法耐药的寻常型天疱疮的一种有用辅助手段。它可最初与皮质类固醇联合使用，能更快改善症状，并具有皮质类固醇节省效应。
