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Pietkiewicz P, Gornowicz-Porowska J, Bowszyc-Dmochowska M, et al. A retrospective study of antihypertensives in pemphigus: a still unchartered odyssey particularly between thiols, amides and phenols. Arch Med Sci. 2015;11(5):1021-7doi: 10.5114/aoms.2015.54857.
Pietkiewicz, P., Gornowicz-Porowska, J., Bowszyc-Dmochowska, M., & Dmochowski, M. (2015). A retrospective study of antihypertensives in pemphigus: a still unchartered odyssey particularly between thiols, amides and phenols. Archives of medical science : AMS, 11(5), 1021-7. https://doi.org/10.5114/aoms.2015.54857
Pietkiewicz, Paweł, et al. "A retrospective study of antihypertensives in pemphigus: a still unchartered odyssey particularly between thiols, amides and phenols." Archives of medical science : AMS vol. 11,5 (2015): 1021-7. doi: https://doi.org/10.5114/aoms.2015.54857
Pietkiewicz P, Gornowicz-Porowska J, Bowszyc-Dmochowska M, Dmochowski M. A retrospective study of antihypertensives in pemphigus: a still unchartered odyssey particularly between thiols, amides and phenols. Arch Med Sci. 2015 Oct 12;11(5):1021-7. doi: 10.5114/aoms.2015.54857. PMID: 26528346; PMCID: PMC4624747.
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Arch Med Sci. 2015 Oct 12;11(5):1021-7. doi: 10.5114/aoms.2015.54857.

A retrospective study of antihypertensives in pemphigus: a still unchartered odyssey particularly between thiols, amides and phenols.

Archives of medical science : AMS

Paweł Pietkiewicz, Justyna Gornowicz-Porowska, Monika Bowszyc-Dmochowska, Marian Dmochowski

Affiliations

  1. Cutaneous Histopathology and Immunopathology Section, Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland.

PMID: 26528346 PMCID: PMC4624747 DOI: 10.5114/aoms.2015.54857

Abstract

INTRODUCTION: Autoimmune pemphigus diseases comprise several entities with serious prognoses, including the pemphigus vulgaris (PV) group and pemphigus foliaceus (PF) group. Antihypertensives are suspected to be one of the factors triggering/sustaining pemphigus. Here, the data of pemphigus patients regarding arterial hypertension (AH) and taking potentially noxious drugs were statistically analyzed in a setting of a Polish university dermatology department.

MATERIAL AND METHODS: Medical histories of pemphigus patients (40 admissions of 24 female patients - 13 PV, 11 PF; and 102 admissions of 38 male patients - 24 PV, 14 PF), diagnosed at both immunopathological and biochemical-molecular levels, were studied.

RESULTS: Ten of 16 (62.50%) AH-positive PV patients received known PV triggers/sustainers 11 times (1-3 per patient). Fourteen of 15 (93.33%) AH-positive PF patients received known PF triggers/sustainers 21 times (1-3 per patient). No differences in numbers of patients taking potentially culprit drugs were shown between PV and PF (Fisher's exact test: p = 0.0829; Yates' χ(2) test: p = 0.1048). The most frequently used culprit drugs were ramipril in PV and enalapril in PF. On average, each PV/PF AH-positive patient received 3.161 different antihypertensives in his/her history of admissions (2.155 antihypertensives per admission).

CONCLUSIONS: Drug triggering should be suspected in every case of newly diagnosed or exacerbated pemphigus, as eliminating possible PV/PF triggers/sustainers may alleviate the clinical symptoms and enable the decrease of dose/range of immunosuppressants regardless of pemphigus form. Eliminating possible drug PV/PF triggers/sustainers may alleviate the clinical symptoms and enable the decrease of dose/range of immunosuppressants regardless of pemphigus form.

Keywords: drug-induced; hypertension; pemphigus; precipitating factors; treatment

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