Immunopathological examination of esophagus as a useful criterion of cure in pemphigus vulgaris

Background We performed histopathological and immunopathological examinatio ns of the esophagus in patients with pemphigus vulgaris during clinical rem ission. Methods In the group of 14 patients without serum antibodies, five were tre ated with low doses of steroids and cyclophosphamide (as maintenance treatm ent). while nine had already completed the therapy. Results In all five cases under maintenance treatment we found bound pemphi gus antibodies in vivo. Acantholysis was present in two of these. In all ni ne non-treated patients, acantholysis and immunopathological findings were negative. Conclusions Our studies reveal that the absence of bound 'pemphigus vulgari s' antibodies in the esophagus by immunological examination could be regard ed as proof of complete cure and could be the decisive finding to stop pemp higus treatment. (C) 1999 Elsevier Science B.V. All rights reserved.