Dexamethasone Cyclophosphamide Pulse Therapy in Immunobullous Diseases.

Sindhu, N (2007) Dexamethasone Cyclophosphamide Pulse Therapy in Immunobullous Diseases. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION : Pemphigus Vulgaris is a chronic autoimmune blistering disease of skin and mucous membrane. Prior to the advent of corticosteroids, the majority of patients with Pemphigus Vulgaris died from overwhelming sepsis. After introduction of systemic steroids, survival has improved dramatically. However mortality and morbidity is still very high due to steroid related side effects. Adjuvants like Azathioprine, Methotrexate and Cyclophosphamide were added to the treatment of Pemphigus Vulgaris to reduce the high morbidity associated with long term use of oral steroids. Pulse therapy refers to the administration of a drug intermittently to accelerate the therapeutic efficacy. Pulse therapy using a combination of Corticosteroids and Cyclophosphamide is reported to reduce the mortality and morbidity of Pemphigus Vulgaris. This was introduced by Pasricha et al and by Kanwar. AIM OF THE STUDY : To study the compliance and complications of Dexamethasone Cyclophosphamide Pulse therapy in the management of Immunobullous diseases. CONCLUSION : The results of the study indicate a high degree of positive outcome among patients diagnosed with immunobullous disease(Pemphigus vulgaris and Bullous Pemphigoid) 1) Clinical remission was achieved in 90.5% of the patients. 2) The time taken to attain complete remission was 5.7 pulses. 3) The response did not show much correlation with the severity of the disease. 4) There appeared to be correlation between the response and the duration of the disease at the initiation of therapy. 5) Patients with Bullous pemphigoid (irrespective of the severity and duration of disease) showed a faster response than Pemphigus vulgaris. 6) The common complications noted were menstrual irregularities and weakness. The other side effects noted in order of priority were arthragia, infections, rise in fasting blood sugar, palpitations, diarrhoea, head ache, taste loss, weight gain,avascular necrosis, increase in blood pressure, hiccups, psychosis, sleep disturbances, blurring of vision, stria. The serious complication noted was avascular necrosis of head of femur. 7) There was no cases of relapse or mortality associated with the therapy.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Dexamethasone ; Cyclophosphamide ; Pulse Therapy ; Immunobullous Diseases.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Subramani R
Date Deposited: 05 Jul 2017 01:52
Last Modified: 05 Jul 2017 08:26

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