Methylprednisolone combined with mycophenolate mofetil for the treatment of oral mucosal pemphigoid:a case report and literature review
10.12016/j.issn.2096-1456.2024.08.006
- VernacularTitle:甲泼尼龙联合吗替麦考酚酯治疗口腔黏膜类天疱疮1例报道及文献回顾
- Author:
Xiaoqin XIONG
1
;
Feng GAO
;
Wenxia MENG
Author Information
1. 南方医科大学口腔医院(口腔医学院)牙周黏膜病科,广东 广州(510280)
- Keywords:
pemphigoid;
immune diseases;
glucocorticoids;
mycophenolate mofetil;
immunosuppressants;
hydroxychloroquine sulfate;
thalidomide capsules;
side effects
- From:
Journal of Prevention and Treatment for Stomatological Diseases
2024;32(8):614-619
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the application of mycophenolate mofetil(MMF)in oral mucosal pemphigoid and provide a clinical reference.Methods One case of glucocorticoids combined with MMF in the treatment of oral mucosal pemphigoid was reported,and the clinical application of MMF in oral mucosa-related bullous diseases was dis-cussed.Results One patient with a clinical diagnosis of"oral mucosal pemphigoid"was treated with methylpredniso-lone(36 mg,qd,morning dose)or combined hydroxychloroquine sulfate(0.1 g/time,bid)and thalidomide capsules(50 mg,qd,bedtime)and other drugs.The patient's disease was slowly controlled but prone to recurrence.The treat-ment regimen was immediately adjusted,i.e.,methylprednisolone(36 mg,qd,morning dose)was combined with MMF(0.5 g/time,bid)for 2 weeks,which resulted in ideal lesion healing control.After 8 weeks of methylprednisolone com-bined with MMF,the dose of methylprednisolone was gradually reduced to 12 mg,qd,and MMF was reduced to 0.5 g,qd,the patient's symptoms improved significantly,and no obvious lesions were found in the mouth.The dose was then reduced and maintained according to the principle of pemphigoid treatment.Methylprednisolone(8 mg,qd,morning dose)and MMF(0.5 g,qd)have been used for 6 months of maintenance treatment,and they are still being followed up.As yet,the patient's condition is stable without obvious lesions and new blisters,and no obvious side effects have been observed.A review of the literature shows that MMF is widely used in the field of dermatology to treat a variety of im-mune diseases,such as connective tissue diseases and autoimmune blistering diseases.According to the reports of ad-verse reactions to MMF,digestive system reactions are the most common adverse reactions;therefore,patients with ac-tive gastrointestinal diseases should be treated with caution,followed by bone marrow suppression,and it is recommend-ed to monitor liver function and blood routine in patients using MMF.The safety and efficacy of MMF for treating pem-phigoid involving the skin have been reported in the literature,but oral mucosal doctors still lack experience for treating mucous membrane pemphigoid.Conclusions As a new immunosuppressant,MMF has high safety and no obvious side effects and can be considered as a combination adjuvant drug for patients with severe clinical disease and refractory oral mucosal pemphigoid.
