Pemfigoid mukozne membrane

  • Ivana Jocić Military Medical Academy, Department of Dermatology and Venereology
  • Dragana Daković Military Medical Academy, Department of Dentistry
  • Lidija Kandolf Sekulović Military Medical Academy, Department of Dermatology and Venereology
  • Ljubomir Novaković Queen Elizabeth Hospital, Lewisham and Greenwich NHS Trust & St John's Institute of Dermatology, Guy's and St Thomas' NHS Trust, London, United Kingdom
  • Željko Mijušković Military Medical Academy, Department of Dermatology and Venereology
DOI: https://doi.org/10.2298/VSP210801098J
Keywords: diagnosis;, bullous pemphigoid;, enzyme-linked immunosorbent assay;, fluorescent antibody technique, direct;, remission induction

Abstract


Uvod. Pemfigoid mukozne membrane (PMM) je retka autoimunska, hronična inflamacijska bolest, koja utiče na sluzokože, najčešće očiju i usta, sa ili bez promena na koži. To je složena bolest sa nekoliko komplikacija, koje uključuju ožiljke, posebno na sluzokoži konjunktiva, što može dovesti do gubitka vida. Prikaz bolesnika. Prikazana su četiri bolesnika (dva muškarca i dve žene) sa PMM. Kod svih bolesnika bolest se javila u osmoj deceniji života. Dijagnoza je potvrđena na osnovu kliničke slike, histološkog nalaza, analiza drektne i indirektne imunofluorescence, indirektne split-skin tehnike i testa – enzyme-linked immunosorbent assay (ELISA). Većina lezija nalazila se na desnima i sluzokoži obraza, a kod jednog bolesnika bio je zahvaćen grkljan i postojala je lezija na pupku. Oči nisu bile zahvaćene i nisu primećene promene sumnjive na malignitet. Kod dva bolesnika testovima direktne imunofluoroescence otkriveno je kontinuirano linearno taloženje IgG u zoni bazalne membrane i oni su lečeni oralnim nikotianimidima i tetraciklin hidrohloridom. Kod dva bolesnika otkrili smo linearno nataložene IgG zajedno sa IgA i oni su lečeni metilprednizolonom. Kod svih bolesnika je ostvarena potpuna remisija. Zaključak. Za dugoročnu kontrolu bolesti i smanjenje komplikacija povezanih sa PMM neophodni su rana dijagnoza i multidisciplinarni pristup u lečenju obolelih.

References

800x600

Normal

0

false

false

false

EN-US

X-NONE

X-NONE

MicrosoftInternetExplorer4

DefSemiHidden="false" DefQFormat="false" DefPriority="99"

LatentStyleCount="371">

UnhideWhenUsed="true" QFormat="true" Name="heading 2"/>

UnhideWhenUsed="true" QFormat="true" Name="heading 3"/>

UnhideWhenUsed="true" QFormat="true" Name="heading 4"/>

UnhideWhenUsed="true" QFormat="true" Name="heading 5"/>

UnhideWhenUsed="true" QFormat="true" Name="heading 6"/>

UnhideWhenUsed="true" QFormat="true" Name="heading 7"/>

UnhideWhenUsed="true" QFormat="true" Name="heading 8"/>

UnhideWhenUsed="true" QFormat="true" Name="heading 9"/>

Name="index 1"/>

Name="index 2"/>

Name="index 3"/>

Name="index 4"/>

Name="index 5"/>

Name="index 6"/>

Name="index 7"/>

Name="index 8"/>

Name="index 9"/>

UnhideWhenUsed="true" Name="toc 1"/>

UnhideWhenUsed="true" Name="toc 2"/>

UnhideWhenUsed="true" Name="toc 3"/>

UnhideWhenUsed="true" Name="toc 4"/>

UnhideWhenUsed="true" Name="toc 5"/>

UnhideWhenUsed="true" Name="toc 6"/>

UnhideWhenUsed="true" Name="toc 7"/>

UnhideWhenUsed="true" Name="toc 8"/>

UnhideWhenUsed="true" Name="toc 9"/>

Name="Normal Indent"/>

Name="footnote text"/>

Name="annotation text"/>

Name="header"/>

Name="footer"/>

Name="index heading"/>

UnhideWhenUsed="true" QFormat="true" Name="caption"/>

Name="table of figures"/>

Name="envelope address"/>

Name="envelope return"/>

Name="footnote reference"/>

Name="annotation reference"/>

Name="line number"/>

Name="page number"/>

Name="endnote reference"/>

Name="endnote text"/>

Name="table of authorities"/>

Name="macro"/>

Name="toa heading"/>

Name="List"/>

Name="List Bullet"/>

Name="List Number"/>

Name="List 2"/>

Name="List 3"/>

Name="List 4"/>

Name="List 5"/>

Name="List Bullet 2"/>

Name="List Bullet 3"/>

Name="List Bullet 4"/>

Name="List Bullet 5"/>

Name="List Number 2"/>

Name="List Number 3"/>

Name="List Number 4"/>

Name="List Number 5"/>

Name="Closing"/>

Name="Signature"/>

UnhideWhenUsed="true" Name="Default Paragraph Font"/>

Name="Body Text"/>

Name="Body Text Indent"/>

Name="List Continue"/>

Name="List Continue 2"/>

Name="List Continue 3"/>

Name="List Continue 4"/>

Name="List Continue 5"/>

Name="Message Header"/>

Name="Salutation"/>

Name="Date"/>

Name="Body Text First Indent"/>

Name="Body Text First Indent 2"/>

Name="Note Heading"/>

Name="Body Text 2"/>

Name="Body Text 3"/>

Name="Body Text Indent 2"/>

Name="Body Text Indent 3"/>

Name="Block Text"/>

Name="Hyperlink"/>

Name="FollowedHyperlink"/>

Name="Document Map"/>

Name="Plain Text"/>

Name="E-mail Signature"/>

Name="HTML Top of Form"/>

Name="HTML Bottom of Form"/>

Name="Normal (Web)"/>

Name="HTML Acronym"/>

Name="HTML Address"/>

Name="HTML Cite"/>

Name="HTML Code"/>

Name="HTML Definition"/>

Name="HTML Keyboard"/>

Name="HTML Preformatted"/>

Name="HTML Sample"/>

Name="HTML Typewriter"/>

Name="HTML Variable"/>

Name="Normal Table"/>

Name="annotation subject"/>

Name="No List"/>

Name="Outline List 1"/>

Name="Outline List 2"/>

Name="Outline List 3"/>

Name="Table Simple 1"/>

Name="Table Simple 2"/>

Name="Table Simple 3"/>

Name="Table Classic 1"/>

Name="Table Classic 2"/>

Name="Table Classic 3"/>

Name="Table Classic 4"/>

Name="Table Colorful 1"/>

Name="Table Colorful 2"/>

Name="Table Colorful 3"/>

Name="Table Columns 1"/>

Name="Table Columns 2"/>

Name="Table Columns 3"/>

Name="Table Columns 4"/>

Name="Table Columns 5"/>

Name="Table Grid 1"/>

Name="Table Grid 2"/>

Name="Table Grid 3"/>

Name="Table Grid 4"/>

Name="Table Grid 5"/>

Name="Table Grid 6"/>

Name="Table Grid 7"/>

Name="Table Grid 8"/>

Name="Table List 1"/>

Name="Table List 2"/>

Name="Table List 3"/>

Name="Table List 4"/>

Name="Table List 5"/>

Name="Table List 6"/>

Name="Table List 7"/>

Name="Table List 8"/>

Name="Table 3D effects 1"/>

Name="Table 3D effects 2"/>

Name="Table 3D effects 3"/>

Name="Table Contemporary"/>

Name="Table Elegant"/>

Name="Table Professional"/>

Name="Table Subtle 1"/>

Name="Table Subtle 2"/>

Name="Table Web 1"/>

Name="Table Web 2"/>

Name="Table Web 3"/>

Name="Balloon Text"/>

Name="Table Theme"/>

Name="List Paragraph"/>

Name="Intense Quote"/>

Name="Subtle Emphasis"/>

Name="Intense Emphasis"/>

Name="Subtle Reference"/>

Name="Intense Reference"/>

UnhideWhenUsed="true" Name="Bibliography"/>

UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>

Name="Grid Table 1 Light Accent 1"/>

Name="Grid Table 6 Colorful Accent 1"/>

Name="Grid Table 7 Colorful Accent 1"/>

Name="Grid Table 1 Light Accent 2"/>

Name="Grid Table 6 Colorful Accent 2"/>

Name="Grid Table 7 Colorful Accent 2"/>

Name="Grid Table 1 Light Accent 3"/>

Name="Grid Table 6 Colorful Accent 3"/>

Name="Grid Table 7 Colorful Accent 3"/>

Name="Grid Table 1 Light Accent 4"/>

Name="Grid Table 6 Colorful Accent 4"/>

Name="Grid Table 7 Colorful Accent 4"/>

Name="Grid Table 1 Light Accent 5"/>

Name="Grid Table 6 Colorful Accent 5"/>

Name="Grid Table 7 Colorful Accent 5"/>

Name="Grid Table 1 Light Accent 6"/>

Name="Grid Table 6 Colorful Accent 6"/>

Name="Grid Table 7 Colorful Accent 6"/>

Name="List Table 1 Light Accent 1"/>

Name="List Table 6 Colorful Accent 1"/>

Name="List Table 7 Colorful Accent 1"/>

Name="List Table 1 Light Accent 2"/>

Name="List Table 6 Colorful Accent 2"/>

Name="List Table 7 Colorful Accent 2"/>

Name="List Table 1 Light Accent 3"/>

Name="List Table 6 Colorful Accent 3"/>

Name="List Table 7 Colorful Accent 3"/>

Name="List Table 1 Light Accent 4"/>

Name="List Table 6 Colorful Accent 4"/>

Name="List Table 7 Colorful Accent 4"/>

Name="List Table 1 Light Accent 5"/>

Name="List Table 6 Colorful Accent 5"/>

Name="List Table 7 Colorful Accent 5"/>

Name="List Table 1 Light Accent 6"/>

Name="List Table 6 Colorful Accent 6"/>

Name="List Table 7 Colorful Accent 6"/>

/* Style Definitions */

table.MsoNormalTable

{mso-style-name:"Table Normal";

mso-tstyle-rowband-size:0;

mso-tstyle-colband-size:0;

mso-style-noshow:yes;

mso-style-priority:99;

mso-style-parent:"";

mso-padding-alt:0cm 5.4pt 0cm 5.4pt;

mso-para-margin:0cm;

mso-para-margin-bottom:.0001pt;

mso-pagination:widow-orphan;

font-size:10.0pt;

font-family:"Times New Roman",serif;}

1.      Madgar O, Baniel A, Yarom N, Glikson E, Zeeli T, Sprecher E, et al. Mucous membrane pemphigoid–otorhinolaryngological manifestations: a retrospective cohort study. Eur Arch Otorhinolaryngol, 2020; 277(3): 939–45.

2.      Ormond M, McParland H, Thakrar P, Donaldson ANA, Andiappan M, Cook RJ, et al. Validation of an Oral Disease Severity Score (ODSS) tool for use in oral mucous membrane pemphigoid. Br J Dermatol 2020; 183(1): 78‒85.

3.      Kamaguchi M, Iwata H. The Diagnosis and Blistering Mechanisms of Mucous Membrane Pemphigoid. Front Immunol 2019; 10: 34.

4.      Lee J, Seiffert-Sinha K, Attwood K, Sinha AA. A Retrospective Study of Patient-Reported Data of Bullous Pemphigoid and Mucous Membrane Pemphigoid From a US-Based Registry. Front Immunol 2019; 10: 2219.

5.      La Placa M, Balestri R, Tartari F, Sechi A, Ferrara F, Loi C, et al. Mucous Membrane Pemphigoid-Associated Malignancies: Case Series and a Brief Overview of the Literature. Dermatol Pract Concept 2019; 9(2): 119‒25.

6.      Mustafa MB, Porter SR, Smoller BR, Sitaru C. Oral mucosal manifestations of autoimmune skin diseases. Autoimmun Rev 2015; 14(10): 930‒51.

7.      Shruthi R, Shruthi H, Vidya A, Subhas B, Sajad AB. Pemphigus vulgaris presenting as bleeding gums: A case report. J Turgut Ozal Med Cent 2017; 24(3): 324‒7.

8.      Georgoudis P, Sabatino F, Szentmary N, Palioura S, Fodor E, Hamada S, et al. Ocular Mucous Membrane Pemphigoid: Current State of Pathophysiology, Diagnostics and Treatment. Ophthalmol Ther 2019; 8(1): 5‒17.

9.      Wickmanns JE. Ideas on the diagnosis. Hanover: Helwig; 1894. p. 89.

10.   Arduino PG, Broccoletti R, Carbone M, Conrotto D, Pettigiani E, Giacometti S, et al. Describing the gingival involvement in a sample of 182 Italian predominantly oral mucous membrane pemphigoid patients: A retrospective series. Med Oral Patol Oral Cir Bucal 2017; 22(2): e149–52.

11.   Di Zenzo G, Carrozzo M, Chan LS. Urban legend series: mucous membrane pemphigoid. Oral Dis 2014; 20(1): 35‒54.

12.   Chan LS, Ahmed AR, Anhalt GJ, Bernauer W, Cooper KD, Elder MJ, et al. The first international consensus on mucous membrane pemphigoid: definition, diagnostic criteria, pathogenic factors, medical treatment, and prognostic indicators. Arch Dermatol 2002; 138(3): 370‒9.

13.   Neff AG, Turner M, Mutasim DF. Treatment strategies in mucosus membrane pemphigoid. Ther Clin Risk Manag 2008; 4(3): 617–26.

14.   Hasan S. Desquamative gingivitis - A clinical sign in mucous membrane pemphigoid: Report of a case and review of literature. J Pharm Bioallied Sci 2014; 6(2): 122‒6.

15.   Santi CG, Gripp AC, Roselino AM, Mello DS, Gordilho JO, Marsillac PF, et al. Consensus on the treatment of autoimmune bullous dermatoses: bullous pemphigoid, mucous membrane pemphigoid and epidermolysis bullosa acquisita - Brazilian Society of Dermatology. An Bras Dermatol 2019; 94(2 Suppl 1): 33‒47.

16.   Egan CA, Lazarova Z, Darling TN, Yee C, Yancey KB. Anti-epiligrin cicatricial pemphigoid: clinical findings, immunopathogenesis, and significant associations. Medicine (Baltimore) 2003; 82(3): 177‒86.

17.   Ujiie H, Iwata H, Yamagami J, Nakama T, Aoyama Y, Ikeda S, et al. Committee for Guidelines for the Management of Pemphigoid Diseases (Including Epidermolysis Bullosa Acquisita). Japanese guidelines for the management of pemphigoid (including epidermolysis bullosa acquisita). J Dermatol 2019; 46(12): 1102‒35.

18.   Witte M, Zillikens D, Schmidt E. Diagnosis of Autoimmune Blistering Diseases. Front Med (Lausanne) 2018; 5: 296.

19.   Feliciani C, Joly P, Jonkman MF, Zambruno G, Zillikens D, Ioannides D, et al. Management of bullous pemphigoid: the European Dermatology Forum consensus in collaboration with the European Academy of Dermatology and Venereology. Br J Dermatol 2015; 172(4): 867‒77.

20.   Sacher C, Hunzelmann N. Cicatricial pemphigoid (mucous membrane pemphigoid): current and emerging therapeutic approaches. Am J Clin Dermatol 2005

Published
2023/02/13
Issue
Vol. 80 No. 01 (2023): Vojnosanitetski pregled
Section
Case report