Faculty Opinions recommendation of Dupilumab as a novel therapy for bullous pemphigoid: A multicenter case series.

Bullous pemphigoid (BP) is an autoimmune blistering disease of elderly patients that has shown increasing incidence in the last decades. Higher prevalence of BP may be due to more frequent use of provoking agents, such as antidiabetic dipeptidyl peptidase-4 inhibitor (DPP4i) drugs. Our aim was to assess DPP4i-induced bullous pemphigoid among our BP patients and characterize the clinical, laboratory and histological features of this drug-induced disease form. In our patient cohort, out of 127 BP patients (79 females (62.2%), 48 males (37.7%)), 14 (9 females and 5 males) were treated with DPP4i at the time of BP diagnosis. The Bullous Pemphigoid Disease Area Index (BPDAI) urticaria/erythema score was significantly lower, and the BPDAI damage score was significantly higher in DPP4i-BP patients compared to the nonDPP4i group. Both the mean absolute eosinophil number and the mean periblister eosinophil number was significantly lower in DPP4i-BP patients than in nonDPP4i cases (317.7 ± 0.204 vs. 894.0 ± 1.171 cells/μL, p < 0.0001; 6.75 ± 1.72 vs. 19.09 ± 3.1, p = 0.0012, respectively). Our results provide further evidence that DPP4i-associated BP differs significantly from classical BP, and presents with less distributed skin symptoms, mild erythema, normal or slightly elevated peripheral eosinophil count, and lower titers of BP180 autoantibodies. To our knowledge, this is the first case series of DPP4i-related BP with a non-inflammatory phenotype in European patients.

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Autotransfusion of vaginally shed blood as a novel therapy in obstetric hemorrhage: A case series

Transfusion ◽

10.1111/trf.16794 ◽

2022 ◽

Author(s):

Jaclyn M. Phillips ◽

Takahiro Tamura ◽

Jonathan H. Waters ◽

Jacob Larkin ◽

Sara Sakamoto

Keyword(s):

Case Series ◽

Obstetric Hemorrhage ◽

Novel Therapy ◽

Shed Blood

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Treatment of bullous pemphigoid with adjuvant immunoadsorption: A case series

Journal of the American Academy of Dermatology ◽

10.1016/j.jaad.2014.06.014 ◽

2014 ◽

Vol 71 (5) ◽

pp. 1018-1020 ◽

Cited By ~ 17

Author(s):

Michael Kasperkiewicz ◽

Franziska Schulze ◽

Markus Meier ◽

Nina van Beek ◽

Martin Nitschke ◽

...

Keyword(s):

Bullous Pemphigoid ◽

Case Series

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Spontaneous spondylodiscitis and endocarditis: interdisciplinary experience from a tertiary institutional case series and proposal of a treatment algorithm

Neurosurgical Review ◽

10.1007/s10143-021-01640-z ◽

2021 ◽

Author(s):

Lennart Viezens ◽

Marc Dreimann ◽

André Strahl ◽

Annika Heuer ◽

Leon-Gordian Koepke ◽

...

Keyword(s):

Treatment Algorithm ◽

Case Series ◽

Improve Patient Care ◽

Transoesophageal Echocardiography ◽

Simultaneous Presence ◽

Novel Therapy ◽

Therapy Algorithm ◽

Efficient Treatment ◽

Treatment Processes ◽

Delays In Diagnosis

AbstractPreviously, the simultaneous presence of endocarditis (IE) has been reported in 3–30% of spondylodiscitis cases. The specific implications on therapy and outcome of a simultaneous presence of both diseases are not yet fully evaluated. Therefore, the aim of this study was to investigate the influence of a simultaneously present endocarditis on the course of therapy and outcome of spondylodiscitis. A prospective database analysis of 328 patients diagnosed with spontaneous spondylodiscitis (S) using statistical analysis with propensity score matching was conducted. Thirty-six patients (11.0%) were diagnosed with concurrent endocarditis (SIE) by means of transoesophageal echocardiography. In our cohort, the average age was 65.82 ± 4.12 years and 64.9% of patients were male. The incidence of prior cardiac or renal disease was significantly higher in the SIE group (coronary heart disease SIE n = 13/36 vs. S n = 57/292, p < 0.05 and chronic heart failure n = 11/36 vs. S n = 41/292, p < 0.05, chronic renal failure SIE n = 14/36 vs. S n = 55/292, p < 0.05). Complex interdisciplinary coordination and diagnostics lead to a significant delay in surgical intervention (S = 4.5 ± 4.5 days vs. SIE = 8.9 ± 9.5 days, p < 0.05). Mortality did not show statistically significant differences: S (13.4%) and SIE (19.1%). Time to diagnosis and treatment is a key to efficient treatment and patient safety. In order to counteract delayed therapy, we developed a novel therapy algorithm based on the analysis of treatment processes of the SIE group. We propose a clear therapy pathway to avoid frequently observed pitfalls and delays in diagnosis to improve patient care and outcome.

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Bullous pemphigoid in patients receiving peritoneal dialysis: a case series and a literature survey

Renal Failure ◽

10.1080/0886022x.2021.1910045 ◽

2021 ◽

Vol 43 (1) ◽

pp. 651-657

Author(s):

Kohkichi Morimoto ◽

Tadashi Yoshida ◽

Naoki Washida ◽

Kiyotaka Uchiyama ◽

Takashin Nakayama ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Bullous Pemphigoid ◽

Case Series ◽

Literature Survey

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Gliptin-Induced Bullous Pemphigoid: Canadian Case Series of 10 Patients

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475420972349 ◽

2020 ◽

pp. 120347542097234

Author(s):

Miriam Armanious ◽

Mohn’d AbuHilal

Keyword(s):

Bullous Pemphigoid ◽

Case Series ◽

Rapid Improvement ◽

Drug Induced ◽

Dipeptidyl Peptidase 4 ◽

Early Withdrawal ◽

Immune Mediated ◽

Dipeptidyl Peptidase 4 Inhibitors ◽

Causative Agents

Background Bullous pemphigoid (BP) is a chronic immune-mediated vesiculobullous disorder. Recently, several reports have described dipeptidyl peptidase-4 inhibitors, also known as gliptins, as causative agents for drug-induced BP. Objective To report and describe clinical and histologic characteristics of 10 cases of gliptin-induced BP. Results We identified 10 patients with gliptin-induced BP. Nine were secondary to linagliptin, and 1 case was attributed to sitagliptin. All patients showed significant improvement after withdrawal of gliptin medications and proper medical treatment. There has been no evidence of relapse after 4 months of follow-up. Conclusion This report supports the proposed association between gliptins and BP. Physicians should be aware of this potential adverse effect, as gliptin-induced BP can be reversible once identified and the responsible medication is stopped. Early withdrawal of the offending drug and proper treatment can lead to rapid improvement and reduced morbidity.

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Bullous pemphigoid: a case series with emphasis on long-term remission off therapy

Journal of Dermatological Treatment ◽

10.3109/09546634.2012.660519 ◽

2012 ◽

Vol 24 (5) ◽

pp. 327-331 ◽

Cited By ~ 3

Author(s):

Shawn G. Kwatra ◽

Joseph L. Jorizzo

Keyword(s):

Bullous Pemphigoid ◽

Case Series

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Gastric peroral endoscopic myotomy for the treatment of refractory gastroparesis: a multicenter international experience

Endoscopy ◽

10.1055/a-0596-7199 ◽

2018 ◽

Cited By ~ 11

Author(s):

Michel Kahaleh ◽

Jean-Michel Gonzalez ◽

Ming-ming Xu ◽

Iman Andalib ◽

Monica Gaidhane ◽

...

Keyword(s):

Gastric Emptying ◽

Hospital Stay ◽

Case Series ◽

Length Of Hospital Stay ◽

Novel Therapy ◽

Gastric Emptying Scintigraphy ◽

Post Procedure ◽

The Mean ◽

Procedure Duration

Abstract Background Gastroparesis is a difficult-to-treat motility disorder with a poor response to medical therapy. Gastric peroral endoscopic pyloromyotomy (G-POEM) has been offered as a novel therapy in the treatment of refractory gastroparesis. We present a multicenter case series of our experience with G-POEM. Methods This is an international multicenter case series of patients who underwent G-POEM for the treatment of gastroparesis. The severity of gastroparesis was assessed by delayed gastric emptying scintigraphy (GES) and an elevated gastroparesis cardinal symptoms index (GCSI). Patients then underwent G-POEM using the submucosal tunneling technique. The primary endpoint was improvement in the GCSI score and improvement in gastric emptying on repeat scintigraphy. Secondary endpoints were technical success, complication rate, procedure duration, and length of hospital stay post-procedure. Results G-POEM was technically successful in all 33 patients. Symptomatic improvement was seen in 28/33 patients (85 %), with a decrease in symptom score by GCSI from 3.3 to 0.8 at follow-up (P < 0.001). The mean procedure duration was 77.6 minutes (37 – 255 minutes). Mean GES improved significantly from 222.4 minutes to 143.16 minutes (P < 0.001). Complications were minimal and included bleeding (n = 1) and an ulcer (n = 1) treated conservatively. The mean length of hospital stay post-procedure was 5.4 days (1 – 14 days). The mean follow-up duration was 11.5 months (2 – 31 months). Conclusion G-POEM is a technically feasible, safe, and successful procedure for the treatment of refractory gastroparesis. A further multicenter comparative study should be performed to compare this technique to laparoscopic pyloromyotomy.

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