PARANEOPLASTIC PEMPHIGUS ASSOCIATED WITH MYASTHENIA-GRAVIS AND CASTLEMANS TUMOR

We report a patient with myasthenia gravis and Castleman's tumour who developed extensive painful erosions on the buccal mucosa. Biopsy spec imens of these lesions showed histological features, consistent with p araneoplastic pemphigus. Direct immunofluorescence displayed findings of pemphigus vulgaris. Circulating antibodies bound to normal human sk in but also to rat bladder epithelium and non-epithelial tissues such as myocardium and liver. Immunoprecipitation studies identified bands of molecular weight of 210 and 190 kDa, characteristic of paraneoplast ic pemphigus.