Publication: Dexamethasone Pulse Therapy in Pemphigus Vulgaris Associated Myocardial Infarction in Resource-Limited Settings
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Date
2022
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Society of Dermatologists, Venereologists and Leprologists of Nepal (SODVELON)
Abstract
Abstract:
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.
Description
Vikash Paudel
National Medical College and Teaching Hospital, Birgunj, Nepal
https://orcid.org/0000-0001-8729-052X
Keywords
Dexamethasone, Myocardial Infarction, Pemphigus vulgaris, Pulse therapy