Pemfiguslu olgularda otoantikor titrelerinin klinik şiddet ve tedaviye yanıtları ilişkisinin değerlendirilmesi
Özet
Assessing The Autoantibody Levels in relation to Disease Severity and Therapy Response in Pemhigus Patients Objective: The purpose of this study is to determine the clinical significance of the autoantibody levels in relation to disease severity and therapy response, as an immunological parameter which can be a support for the clinician, in pemphigus management. Material and Method: The clinical features of 47 pemphigus vulgaris patients were assessed and patient's sera were investigated by indirect immunofluorescence using monkey oesophagus as a substrate for autoantibody levels. Results: The sensitivity of indirect immunofluorescence was %100 in mucosal dominant type and %89 in pemphigus vulgaris generally. Sensitivity was found %92,5 in patients who had not any treatment and %85 in patients who had treatment. A relationship between antibody titers and mucosal severity score was found statistically significant, however there was no relationship between antibody titers and cutaneous and general scores. Initial antibody titers of the patients with at least one mucosal lesion at the first month of therapy, were found significantly higher than the patients who had no mucosal lesion. With therapy, lesions resolved earlier than the antibody titers. The last antibody titers between the patients who had relapse and who had no relapse showed no significant difference. The elevation of the antibody titers with the relapse was seen in 58,8% of patients who had relapse. Conclusion: Sera autoantibody titers, assessed with appropriate technique was helpful in determining disease severity and choosing 50appropriate treatment, especially in patients whose treatment had not began yet. In our study, we found a correlation between antibody levels and mucosal severity with indirect immunofluorescence technique using monkey oesophagus as a substrate. In patients who had treatment, making a relation between the autoantibody levels with disease severity and therapy response was difficult. However antibody levels can be helpful in determining the treatment withdrawal and estimating recurrences earlier in patient follow up.