Clinical course prognosis for the autoimmune pemphigus by evaluation of the character of immunoglobulin fixing in sites of antigen targets localization

摘要

Pemphigus is a severe systemic disease of the organs covered by multilayered flattened epithelium. For some patients, it was enough to use only corticosteroid therapy to achieve clinical remission, whereas for others an additional cytostatic treatment was necessary. The basic diagnostic feature of the autoimmune pemphigus is the detection of fixated IgG in intercellular spaces of epidermis, i.e. in sites of localization of targeted antigens. A long-term clinical-immunopathologic evaluation of 179 pemphigus patients revealed that the immunohistochemical pattern of IgG fixation can be described either as the thin "network", or as the rough granular variation. Presence of fixed IgG in intercellular spaces in the form of thin "network" correlated with a favorable clinical course with clinical remission after treatment only by corticosteroids. Rough granular forms of IgG fixing in the same localization were associated with harsh torpid clinical course that required additional cytostatic treatment. The estimation of the character of the IgG fixation in the intercellular spaces of epidermis allows to predict pemphigus course and to carry out individual therapeutic regimen.