Dexamethasone Pulse Therapy in Pemphigus Vulgaris Associated Myocardial Infarction in Resource-Limited Settings
Pemphigus vulgaris is an autoimmune blistering disorder where biologics are the cornerstone of therapy. In resource-limited settings, a dermatologist should rely on systemic steroids. Dexamethasone pulse therapy is a cheap and established treatment of pemphigus where a supra-pharmacological dose of...
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| Language: | English |
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Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON)
2022-03-01
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| Series: | Nepal Journal of Dermatology, Venereology & Leprology |
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| Online Access: | https://nepjol.info/index.php/NJDVL/article/view/43296 |
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| author | Vikash Paudel |
| author_facet | Vikash Paudel |
| author_sort | Vikash Paudel |
| collection | DOAJ |
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Pemphigus vulgaris is an autoimmune blistering disorder where biologics are the cornerstone of therapy. In resource-limited settings, a dermatologist should rely on systemic steroids. Dexamethasone pulse therapy is a cheap and established treatment of pemphigus where a supra-pharmacological dose of dexamethasone is used. High dose of dexamethasone is supposed to have atherogenic potential which could promote a hypercoagulable state. Here, we report a case of a 30-year-old woman in the resource-limited setting of Nepal, who was under monthly dexamethasone pulse therapy for pemphigus vulgaris, who had an acute episode of ST-segment elevated myocardial infarction. In such setting, although steroids are the cornerstone of therapy in various disorders, physicians should be equally cautious in using a high dose of steroids which might lead to fatal complications. This could probably be the first case report of steroid-induced acute myocardial infarction during treatment of pemphigus worldwide.
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| format | Article |
| id | doaj-art-e6ede2ae64284a25aa53f464c6db512c |
| institution | Kabale University |
| issn | 2091-0231 2091-167X |
| language | English |
| publishDate | 2022-03-01 |
| publisher | Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON) |
| record_format | Article |
| series | Nepal Journal of Dermatology, Venereology & Leprology |
| spelling | doaj-art-e6ede2ae64284a25aa53f464c6db512c2025-08-24T10:05:50ZengSociety of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON)Nepal Journal of Dermatology, Venereology & Leprology2091-02312091-167X2022-03-01201Dexamethasone Pulse Therapy in Pemphigus Vulgaris Associated Myocardial Infarction in Resource-Limited SettingsVikash Paudel0https://orcid.org/0000-0001-8729-052XNational Medical College and Teaching Hospital, Birgunj, Nepal Pemphigus vulgaris is an autoimmune blistering disorder where biologics are the cornerstone of therapy. In resource-limited settings, a dermatologist should rely on systemic steroids. Dexamethasone pulse therapy is a cheap and established treatment of pemphigus where a supra-pharmacological dose of dexamethasone is used. High dose of dexamethasone is supposed to have atherogenic potential which could promote a hypercoagulable state. Here, we report a case of a 30-year-old woman in the resource-limited setting of Nepal, who was under monthly dexamethasone pulse therapy for pemphigus vulgaris, who had an acute episode of ST-segment elevated myocardial infarction. In such setting, although steroids are the cornerstone of therapy in various disorders, physicians should be equally cautious in using a high dose of steroids which might lead to fatal complications. This could probably be the first case report of steroid-induced acute myocardial infarction during treatment of pemphigus worldwide. https://nepjol.info/index.php/NJDVL/article/view/43296DexamethasoneMyocardial InfarctionPemphigus vulgarisPulse therapy |
| spellingShingle | Vikash Paudel Dexamethasone Pulse Therapy in Pemphigus Vulgaris Associated Myocardial Infarction in Resource-Limited Settings Nepal Journal of Dermatology, Venereology & Leprology Dexamethasone Myocardial Infarction Pemphigus vulgaris Pulse therapy |
| title | Dexamethasone Pulse Therapy in Pemphigus Vulgaris Associated Myocardial Infarction in Resource-Limited Settings |
| title_full | Dexamethasone Pulse Therapy in Pemphigus Vulgaris Associated Myocardial Infarction in Resource-Limited Settings |
| title_fullStr | Dexamethasone Pulse Therapy in Pemphigus Vulgaris Associated Myocardial Infarction in Resource-Limited Settings |
| title_full_unstemmed | Dexamethasone Pulse Therapy in Pemphigus Vulgaris Associated Myocardial Infarction in Resource-Limited Settings |
| title_short | Dexamethasone Pulse Therapy in Pemphigus Vulgaris Associated Myocardial Infarction in Resource-Limited Settings |
| title_sort | dexamethasone pulse therapy in pemphigus vulgaris associated myocardial infarction in resource limited settings |
| topic | Dexamethasone Myocardial Infarction Pemphigus vulgaris Pulse therapy |
| url | https://nepjol.info/index.php/NJDVL/article/view/43296 |
| work_keys_str_mv | AT vikashpaudel dexamethasonepulsetherapyinpemphigusvulgarisassociatedmyocardialinfarctioninresourcelimitedsettings |