Telitacicept in combination with systemic steroid therapy in a patient with refractory pemphigus vulgaris and tuberculosis: a case report
- By Yu Zhang,
- Haixia Feng,
- Changxu Han,
- Hao Li,
- Tianmeng Yan,
- Xiaoyan Wu
- and Zhenying Zhang
Pages 549 to 550
Cite this article
- ZHANG, Yu,
- FENG, Haixia,
- HAN, Changxu,
- LI, Hao,
- YAN, Tianmeng,
- WU, Xiaoyan
- and ZHANG, Zhenying,
- Zhang, Yu.,
- et al.
- Zhang, Y.,
- Feng, H.,
- Han, C.,
- Li, H.,
- Yan, T.,
- Wu, X.
- and Zhang, Z.
https://doi.org/10.1684/ejd.2025.4997
Cite this article
- Zhang, Y.,
- Feng, H.,
- Han, C.,
- Li, H.,
- Yan, T.,
- Wu, X.
- and Zhang, Z.
- Zhang, Yu.,
- et al.
- ZHANG, Yu,
- FENG, Haixia,
- HAN, Changxu,
- LI, Hao,
- YAN, Tianmeng,
- WU, Xiaoyan
- and ZHANG, Zhenying,
https://doi.org/10.1684/ejd.2025.4997
Pemphigus vulgaris (PV) is an autoimmune blistering disease characterized by acantholysis, with B-cell activation playing a pivotal role in pathogenesis [1]. The relapse rate in PV patients exceeds 50%, and complications associated with repeated treatments, such as increased risk of infections, make long-term management more challenging [2]. Telitacicept, a novel dual inhibitor targeting BLyS /APRIL (cytokines crucial for the development and survival of mature B cells), has demonstrated notable efficacy and safety in treating autoimmune diseases including systemic lupus erythematosus and IgA nephropathy [3]. However, its application in autoimmune blistering diseases remains to be explored. Herein, we present a case of PV complicated by acute hematogenous disseminated pulmonary tuberculosis due to prolonged systemic steroids and rituximab therapy, who was successfully managed with telitacicept.
A 78-year-old female patient presented with a 14-year history of erythema, blisters and erosions around the scalp, oral mucosa, trunk, and limbs. Histopathological examination revealed suprabasal blister formation, and direct immunofluorescence showed a reticular pattern of IgG and C3 deposition between epidermal keratinocytes (see supplementary material). The elevated levels of anti-desmoglein 1 (Dsg1) and anti-desmoglein 3 (Dsg3) IgG autoantibodies (145.86 U/mL and >400 U/mL, respectively), both surpassing the normal range (<20 U/mL), further confirmed the diagnosis of pemphigus vulgaris (PV)…
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