2023
S2k guidelines on the management of paraneoplastic pemphigus/paraneoplastic autoimmune multiorgan syndrome initiated by the European Academy of Dermatology and Venereology (EADV)
ANTIGA, Emiliano, Rikke BECH, Roberto MAGLIE, Giovanni GENOVESE, Luca BORRADORI et. al.Základní údaje
Originální název
S2k guidelines on the management of paraneoplastic pemphigus/paraneoplastic autoimmune multiorgan syndrome initiated by the European Academy of Dermatology and Venereology (EADV)
Autoři
ANTIGA, Emiliano, Rikke BECH (garant), Roberto MAGLIE, Giovanni GENOVESE, Luca BORRADORI, Barbara BOCKLE, Marzia CAPRONI, Frederic CAUX, Nisha Suyien CHANDRAN, Alberto CORRA, Francesco AMORE, Maryam DANESHPAZHOOH, Dipankar DE, Dario DIDONA, Marian DMOCHOWSKI, Kossara DRENOVSKA, Jan EHRCHEN, Claudio FELICIANI, Matthias GOEBELER, Richard GROVES, Claudia GUENTHER, Sanjeev HANDA, Silke C HOFMANN, Barbara HORVATH, Dimitrios IOANNIDIS, Hana JEDLIČKOVÁ (203 Česká republika, domácí), Cezary KOWALEWSKI, Khalaf KRIDIN, Pascal JOLY, Yen Loo LIM, Branka MARINOVIC, Emanual MAVERAKIS, Joost MEIJER, Aikaterini PATSATSI, Carlo PINCELLI, Catherine PROST, Jane SETTERFIELD, Eli SPRECHER, Dusan SKILJEVIC, Kaisa TASANEN, Soner UZUN, Van Beek NINA, Snejina VASSILEVA, Artem VOROBYEV, Igor VUJIC, Gang WANG, Mingyue WANG, Katarzyna WOZNIAK, Savas YAYLI, Giovanna ZAMBRUNO, Takashi HASHIMOTO, Enno SCHMIDT, Mascaro Jr Jose MANUEL a Angelo Valerio MARZANO
Vydání
Journal of the European Academy of Dermatology and Venereology, HOBOKEN, WILEY, 2023, 0926-9959
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30216 Dermatology and venereal diseases
Stát vydavatele
Spojené státy
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 9.200 v roce 2022
Kód RIV
RIV/00216224:14110/23:00131034
Organizační jednotka
Lékařská fakulta
UT WoS
000958925300001
Klíčová slova anglicky
paraneoplastic pemphigus/paraneoplastic autoimmune multiorgan syndrome
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 30. 1. 2024 12:49, Mgr. Tereza Miškechová
Anotace
V originále
BackgroundParaneoplastic pemphigus (PNP), also called paraneoplastic autoimmune multiorgan syndrome (PAMS), is a rare autoimmune disease with mucocutaneous and multi-organ involvement. PNP/PAMS is typically associated with lymphoproliferative or haematological malignancies, and less frequently with solid malignancies. The mortality rate of PNP/PAMS is elevated owing to the increased risk of severe infections and disease-associated complications, such as bronchiolitis obliterans. ObjectivesThese guidelines summarize evidence-based and expert-based recommendations (S2k level) for the clinical characterization, diagnosis and management of PNP/PAMS. They have been initiated by the Task Force Autoimmune Blistering Diseases of the European Academy of Dermatology and Venereology with the contribution of physicians from all relevant disciplines. The degree of consent among all task force members was included. ResultsChronic severe mucositis and polymorphic skin lesions are clue clinical characteristics of PNP/PAMS. A complete assessment of the patient with suspected PNP/PAMS, requiring histopathological study and immunopathological investigations, including direct and indirect immunofluorescence, ELISA and, where available, immunoblotting/immunoprecipitation, is recommended to achieve a diagnosis of PNP/PAMS. Detection of anti-envoplakin antibodies and/or circulating antibodies binding to the rat bladder epithelium at indirect immunofluorescence is the most specific tool for the diagnosis of PNP/PAMS in a patient with compatible clinical and anamnestic features. Treatment of PNP/PAMS is highly challenging. Systemic steroids up to 1.5 mg/kg/day are recommended as first-line option. Rituximab is also recommended in patients with PNP/PAMS secondary to lymphoproliferative conditions but might also be considered in cases of PNP/PAMS associated with solid tumours. A multidisciplinary approach involving pneumologists, ophthalmologists and onco-haematologists is recommended for optimal management of the patients. ConclusionsThese are the first European guidelines for the diagnosis and management of PNP/PAMS. Diagnostic criteria and therapeutic recommendations will require further validation by prospective studies.