Paraneoplastic Pemphigus Involving the Respiratory and Gastrointestinal Mucosae
Joint Authors
Tachibana, Mitsuhiro
Tsutsumi, Yutaka
Odani, Kentaro
Itoh, Akane
Yanagita, Soshi
Kaneko, Yasuhito
Hashimoto, Takashi
Source
Issue
Vol. 2020, Issue 2020 (31 Dec. 2020), pp.1-8, 8 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2020-06-29
Country of Publication
Egypt
No. of Pages
8
Main Subjects
Abstract EN
Paraneoplastic pemphigus (PNP), an autoimmune mucocutaneous disorder involving the oral and bronchial mucosae, is a rare complication of hematologic malignancy.
Serologically, serum autoantibodies against varied desmosome-related proteins are of notice.
PNP is often lethal due to bronchiolitis obliterans and opportunistic infection.
A 70-year-old Japanese male complained of dry cough, stomatitis, and sore throat.
The lips and oral mucosa were severely eroded, and skin eruptions were seen on the chest and abdomen.
The biopsy features were consistent with PNP, and the deposition of IgG and IgM was shown on the plasma membrane of the involved keratinocytes.
Serological studies demonstrated autoantibodies to desmoglein-3, desmocollins-2 and -3, bullous pemphigoid antigen-1, envoplakin and periplakin.
Systemic evaluation disclosed mantle cell lymphoma, stage 4B.
After chemotherapy, partial remission was reached.
PNP was treated with methylprednisolone and intravenous immunoglobulins, and the oral lesion only temporarily responded.
He died of respiratory failure two months after onset.
Autopsy revealed residual indolent lymphoma and systemic opportunistic infections.
Aspergillus colonized the eroded bronchial/bronchiolar mucosa, associated with extensive vascular invasion.
Coinfection of cytomegalovirus (CMV) and Pneumocystis jirovecii caused interstitial pneumonia.
The oropharyngeal, respiratory, esophageal, and gastrointestinal mucosae were diffusely infected by CMV.
Bronchiolitis obliterans was observed in the peripheral lung.
PNP-related acantholysis-like lesions were microscopically identified in the bronchial and gastrointestinal mucosa.
IgG deposition and cleaved caspase-3-immunoreactive apoptotic cell death were proven in the involved mucosal columnar cells.
Pathogenesis of the mucosal involvement is discussed.
American Psychological Association (APA)
Odani, Kentaro& Itoh, Akane& Yanagita, Soshi& Kaneko, Yasuhito& Tachibana, Mitsuhiro& Hashimoto, Takashi…[et al.]. 2020. Paraneoplastic Pemphigus Involving the Respiratory and Gastrointestinal Mucosae. Case Reports in Pathology،Vol. 2020, no. 2020, pp.1-8.
https://search.emarefa.net/detail/BIM-1150486
Modern Language Association (MLA)
Odani, Kentaro…[et al.]. Paraneoplastic Pemphigus Involving the Respiratory and Gastrointestinal Mucosae. Case Reports in Pathology No. 2020 (2020), pp.1-8.
https://search.emarefa.net/detail/BIM-1150486
American Medical Association (AMA)
Odani, Kentaro& Itoh, Akane& Yanagita, Soshi& Kaneko, Yasuhito& Tachibana, Mitsuhiro& Hashimoto, Takashi…[et al.]. Paraneoplastic Pemphigus Involving the Respiratory and Gastrointestinal Mucosae. Case Reports in Pathology. 2020. Vol. 2020, no. 2020, pp.1-8.
https://search.emarefa.net/detail/BIM-1150486
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1150486