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Are Intravenous Injections The Right Treatment Procedure For Pemphigus Vulgaris?

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Posted on Tue, 17 Mar 2015
Question: My Mother is diagnosed with auto-immune disease (Pemphigus vulgaris) and under oral treatment from 2013 beginning. Following are the medicines she had been taking, Azoran(50mg daily), zemphred(weekly twice), tryptomer 10mg(daily) and shelcal(daily). When the immuno suppressant is reduced (azoran) she again started getting lesions in scalp, arms and in the back.

Since our doctor is far from our place, we are planning to go to another hospital in near by area (they suggested that the treatment is same in both place). Except azoran & shelcal they changed other tablets, theya are trednifolone (1x20mg, 2x5mg) and ranitidine(twice daily). The new doc suggests to get admitted in hospital to take the medicine under supervision and also planning some injection/intravenous treatment.

Want to get the opinion and the treatment procedure.
doctor
Answered by Dr. Prof. Kunal Saha (1 hour later)
Brief Answer:
You may continue the treatment as per your new doctor.

Detailed Answer:
Thanks for asking on HealthcareMagic.

I have gone carefully through the details provided. I think that you mean that the new doctor plans on giving 'prednisolone' as intravenous treatment. This medicine can often be required to control flareups and I am sure that he wants to control such a flare up that might have been triggered by the reduction in dose of the earlier medicines. Although I do not have the specifics of the treatment line that the new doctor has in mind, I think that he is moving in proper lines.

Hope that helps.

Regards
Dr. Kunal Saha
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Prof. Kunal Saha (7 hours later)
Thanks for the prompt reply. I have few follow up questions.

How long this treatment goes generally ? Already my mother is taking medicines(including the zemphred steriod) for 2+years and she is feeling weak these days(she used to be active 2years back and do all household/business works). And FYI, before this treatment she usually never goes to hospital(once in 2 year itself is rare).

what is the best procedure to stop it (pemphigus vulgaris) completely ?
Or rather lowest possible dosage(which will have less side effects) and timeline to go to that level.

Any other general suggestion you have in mind to suggest for the patient.
doctor
Answered by Dr. Prof. Kunal Saha (2 hours later)
Brief Answer:
It will not get cured. Dosage long term

Detailed Answer:
Thanks for writing back.

I understand your dismal situation. The intravenous steroids need to be taken short term to control the flare up but will not cure it completely. After that oral steroids might need to be continued on. Whether they can be stopped and disease modifying agents (DMARDs) can be started, remains upon your treating physician to judge. It is not feasible to comment on the dosing without seeing the patient.

There are no procedures to cure the condition completely.

After the flare up gets controlled, I would suggest you to visit your old doctor (you need to do it very rarely anyway) and discuss your concerns.

Regards
Dr. Kunal Saha
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Shanthi.E
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Answered by
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Dr. Prof. Kunal Saha

General & Family Physician

Practicing since :1954

Answered : 4467 Questions

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Are Intravenous Injections The Right Treatment Procedure For Pemphigus Vulgaris?

Brief Answer: You may continue the treatment as per your new doctor. Detailed Answer: Thanks for asking on HealthcareMagic. I have gone carefully through the details provided. I think that you mean that the new doctor plans on giving 'prednisolone' as intravenous treatment. This medicine can often be required to control flareups and I am sure that he wants to control such a flare up that might have been triggered by the reduction in dose of the earlier medicines. Although I do not have the specifics of the treatment line that the new doctor has in mind, I think that he is moving in proper lines. Hope that helps. Regards Dr. Kunal Saha