Bullous pemphigoid in a renal transplant recipient: a case report and review of the literature

Am J Clin Dermatol. 2009;10(3):197-200. doi: 10.2165/00128071-200910030-00007.

Abstract

Bullous pemphigoid (BP) is an autoimmune disease with chronic, recurrent bullous eruptions. BP has been reported to be associated with drugs, physical stimuli, malignancies, and immune abnormalities. Its association with renal transplant is rare and only four cases have been reported. We present a case of BP in a 52-year-old man with chronic hepatitis B and C infection who underwent a cadaveric renal transplant 13 years earlier. His graft was still functioning well when BP appeared. The occurrence of BP in our patient might be a result of drugs (furosemide or tacrolimus), viruses, or renal allograft. As the patient was receiving regular T-cell immunosuppressant therapy, his BP lesions were recalcitrant to corticosteroid treatment. We discuss the pathogenesis and treatment of such patients.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Administration, Cutaneous
  • Anti-Infective Agents / therapeutic use
  • Clobetasol / administration & dosage
  • Dapsone / therapeutic use
  • Doxycycline / therapeutic use
  • Fatal Outcome
  • Glomerulonephritis, IGA / complications*
  • Glomerulonephritis, IGA / therapy
  • Glucocorticoids / administration & dosage
  • Hepatitis B / complications*
  • Hepatitis C / complications*
  • Humans
  • Kidney Transplantation*
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Niacinamide / therapeutic use
  • Pemphigoid, Bullous / complications*
  • Pemphigoid, Bullous / diagnosis
  • Pemphigoid, Bullous / drug therapy
  • Plasmapheresis
  • Vitamin B Complex / therapeutic use

Substances

  • Anti-Infective Agents
  • Glucocorticoids
  • Vitamin B Complex
  • Niacinamide
  • Dapsone
  • Clobetasol
  • Doxycycline
  • Methylprednisolone