Immunopathological examination of esophagus as a useful criterion of cure in pemphigus vulgaris.

BACKGROUND

We performed histopathological and immunopathological examinations of the esophagus in patients with pemphigus vulgaris during clinical remission.

METHODS

In the group of 14 patients without serum antibodies, five were treated with low doses of steroids and cyclophosphamide (as maintenance treatment), while nine had already completed the therapy.

RESULTS

In all five cases under maintenance treatment we found bound pemphigus antibodies in vivo. Acantholysis was present in two of these. In all nine non-treated patients, acantholysis and immunopathological findings were negative.

CONCLUSIONS

Our studies reveal that the absence of bound 'pemphigus vulgaris' antibodies in the esophagus by immunological examination could be regarded as proof of complete cure and could be the decisive finding to stop pemphigus treatment.