The State of Body Regulatory Systems in Patients with Acantholytic Pemphigus according to Biochemical Studies with Grounding for Step-by-step Pathogenetic Corrective Therapy

The purpose of the work was to establish the state of body regulatory systems with the help of biochemical studies in patients with acantholytic pemphigus and the development of a technique for correcting the revealed disorders at various stages of glucocorticosteroid therapy. Material and methods. We examined thirty patients with vulgar pemphigus (4 men and 26 women) aged 51-72. A complex of biochemical studies was performed four times: before the treatment, after 2-3 weeks of taking shock doses of glucocorticosteroids (stage I), 1.5-2 months after lowering the doses of hormones (Stage II) and after 5-6 months, when the doses of hormones were minimally supporting in the absence of clinical manifestations of pemphigus (stage III). Traditional therapy included glucocorticosteroids, antihypertensives, anti-clotting drugs, diuretics, probiotics, antibiotics, antimycotics, potassium, calcium, antacids, vitamins, microelements. Results and discussion. According to biochemical studies there was a statistically significant decrease in the total protein, an increase in glucose levels, triglycerides, low-density lipoproteins, AlAt, AcAt, total bilirubin, alkaline phosphatase, j-glutamyltranspeptidase, both before treatment and in stages I and II of the treatment. These indicators were normalized at the third stage of treatment with the exception of AlAt, AcAt. The atherogenity index sharply increased in the third stage, which is a threatening symptom for the onset of thrombosis and embolism. Conclusions. The received results allowed additionally to traditional therapy to recommend a rational diet for the correction of disorders, taking statins, hepatoprotectors, injections of reamberin, ATP, cocarboxylase, sodium chloride. The conducted therapy of 30 patients with acantholytic pemphigus allowed to obtain stable remission in all examined, to avoid complications. The proposed method of step-by-step therapy of these patients should be introduced into the practice of dermatovenereologists.