Prospective Study of Pulse Therapy in Childhood Pemphigus Disorders

BACKGROUND: Pemphigus disorders are a group of immunobullous diseases affecting skin and/or mucus membranes. Dexamethasone cyclophosphamide pulse (DCP)/dexamethasone only pulse (DOP) therapy has shown promising results in the management of pemphigus group of diseases in adults. AIM: To evaluate the...

Descripción completa

Detalles Bibliográficos
Autores principales: Katakam, Bhumesh Kumar, Kavitha, S. B., Netha, G. Narsimha Rao, Shahana, M., Sri, T. Satya, Vani, D. Sudha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232984/
https://www.ncbi.nlm.nih.gov/pubmed/30505783
http://dx.doi.org/10.4103/idoj.IDOJ_9_18
_version_ 1783370500464967680
author Katakam, Bhumesh Kumar
Kavitha, S. B.
Netha, G. Narsimha Rao
Shahana, M.
Sri, T. Satya
Vani, D. Sudha
author_facet Katakam, Bhumesh Kumar
Kavitha, S. B.
Netha, G. Narsimha Rao
Shahana, M.
Sri, T. Satya
Vani, D. Sudha
author_sort Katakam, Bhumesh Kumar
collection PubMed
description BACKGROUND: Pemphigus disorders are a group of immunobullous diseases affecting skin and/or mucus membranes. Dexamethasone cyclophosphamide pulse (DCP)/dexamethasone only pulse (DOP) therapy has shown promising results in the management of pemphigus group of diseases in adults. AIM: To evaluate the outcome of pulse therapy (PT) in pediatric cases diagnosed with pemphigus vulgaris (PV). MATERIALS AND METHODS: Prospective study of 12 pediatric cases of PV from 2010 to 2015 and treated with PT in Gandhi Hospital. The patients were treated with DOP therapy, with a dose of 50 mg of dexamethasone in 250 ml of 5% dextrose in pediatric patients below the age of 12 years and 100 mg of dexamethasone in 500 ml of 5% dextrose for above 12 years, for three consecutive days. No interpulse steroids or rituximab were given to any patients in our study. RESULTS: Out of 12 cases, 10 were female and 2 were male children. Four cases were below the age of 12 years and 8 cases were above the age of 12 years. The lowest age was 11 years female and highest age was 16 years male child. Average duration of illness is between 4 and 6 months. Six cases completed three phases, four cases were in phase II cycle 7, and two cases were in phase IV. In majority of cases clinical improvement was observed between 2 and 4 pulses in phase I. No significant adverse effects were observed in any case except in two cases who developed headache, shivering, and nausea in first one to two pulses of phase I and managed conservatively. CONCLUSION: Our study shows that PT gives good response in the management of pemphigus in children, in terms of remission and side effects. There was no significant major adverse effect as observed in adults. In low-resource centers such as government institution, PT would be one option. Further studies and long-term follow-up are required to weigh the risks and benefits of PT in pediatric age group.
format Online
Article
Text
id pubmed-6232984
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-62329842018-11-30 Prospective Study of Pulse Therapy in Childhood Pemphigus Disorders Katakam, Bhumesh Kumar Kavitha, S. B. Netha, G. Narsimha Rao Shahana, M. Sri, T. Satya Vani, D. Sudha Indian Dermatol Online J Brief Report BACKGROUND: Pemphigus disorders are a group of immunobullous diseases affecting skin and/or mucus membranes. Dexamethasone cyclophosphamide pulse (DCP)/dexamethasone only pulse (DOP) therapy has shown promising results in the management of pemphigus group of diseases in adults. AIM: To evaluate the outcome of pulse therapy (PT) in pediatric cases diagnosed with pemphigus vulgaris (PV). MATERIALS AND METHODS: Prospective study of 12 pediatric cases of PV from 2010 to 2015 and treated with PT in Gandhi Hospital. The patients were treated with DOP therapy, with a dose of 50 mg of dexamethasone in 250 ml of 5% dextrose in pediatric patients below the age of 12 years and 100 mg of dexamethasone in 500 ml of 5% dextrose for above 12 years, for three consecutive days. No interpulse steroids or rituximab were given to any patients in our study. RESULTS: Out of 12 cases, 10 were female and 2 were male children. Four cases were below the age of 12 years and 8 cases were above the age of 12 years. The lowest age was 11 years female and highest age was 16 years male child. Average duration of illness is between 4 and 6 months. Six cases completed three phases, four cases were in phase II cycle 7, and two cases were in phase IV. In majority of cases clinical improvement was observed between 2 and 4 pulses in phase I. No significant adverse effects were observed in any case except in two cases who developed headache, shivering, and nausea in first one to two pulses of phase I and managed conservatively. CONCLUSION: Our study shows that PT gives good response in the management of pemphigus in children, in terms of remission and side effects. There was no significant major adverse effect as observed in adults. In low-resource centers such as government institution, PT would be one option. Further studies and long-term follow-up are required to weigh the risks and benefits of PT in pediatric age group. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6232984/ /pubmed/30505783 http://dx.doi.org/10.4103/idoj.IDOJ_9_18 Text en Copyright: © 2018 Indian Dermatology Online Journal http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Brief Report
Katakam, Bhumesh Kumar
Kavitha, S. B.
Netha, G. Narsimha Rao
Shahana, M.
Sri, T. Satya
Vani, D. Sudha
Prospective Study of Pulse Therapy in Childhood Pemphigus Disorders
title Prospective Study of Pulse Therapy in Childhood Pemphigus Disorders
title_full Prospective Study of Pulse Therapy in Childhood Pemphigus Disorders
title_fullStr Prospective Study of Pulse Therapy in Childhood Pemphigus Disorders
title_full_unstemmed Prospective Study of Pulse Therapy in Childhood Pemphigus Disorders
title_short Prospective Study of Pulse Therapy in Childhood Pemphigus Disorders
title_sort prospective study of pulse therapy in childhood pemphigus disorders
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6232984/
https://www.ncbi.nlm.nih.gov/pubmed/30505783
http://dx.doi.org/10.4103/idoj.IDOJ_9_18
work_keys_str_mv AT katakambhumeshkumar prospectivestudyofpulsetherapyinchildhoodpemphigusdisorders
AT kavithasb prospectivestudyofpulsetherapyinchildhoodpemphigusdisorders
AT nethagnarsimharao prospectivestudyofpulsetherapyinchildhoodpemphigusdisorders
AT shahanam prospectivestudyofpulsetherapyinchildhoodpemphigusdisorders
AT sritsatya prospectivestudyofpulsetherapyinchildhoodpemphigusdisorders
AT vanidsudha prospectivestudyofpulsetherapyinchildhoodpemphigusdisorders