ABSTRACT
Pemphigus vulgaris is a life threatening, blistering skin disease. It is an autoimmune abnormality. Due to involvement of oral cavity and pharynx, patients are at risk of nutrients deficiency. The aim of this study was to evaluate the status of selenium, copper, and zinc in these patients. In a case-control study, 43 newly diagnosed pemphigus vulgaris patients were compared with 58 healthy people from 2009 to 2010. The severity of the disease was estimated according to Harman's scores. Serum selenium was measured with atomic absorption but serum zinc and copper concentrations were determined spectrophotometrically. Data were compared with independent t test. Correlations were evaluated by Pearson correlation test. Both groups were the same based on sex, age, and weight and body mass index. The mean duration of disease was 5.6 month. The oral and skin severities were 1.79 and 2.3 respectively, based on Harman's scores. Serum selenium of pemphigus patients was significantly less than that of healthy people [P<0.001]. Serum copper was negatively correlated with duration of disease in males [P=0.02, r=-0.5]. Pemphigus vulgaris negatively affects on serum selenium, copper and zinc. It seems that serum selenium, copper and zinc decrease as the disease lasts longer
ABSTRACT
The natural history of ocular lesions in Behcet's disease is toward severe loss of vision/blindness in few years, whereas cytotoxic drugs have changed the outcome. Several open labeled cohort studies showed pulse cyclophosphamide [PCP] to be the best choice. Since one third of these patients are resistant to PCP it is important to know how much improve ment one can expect from the responders. To address this question, we selected patients who improved or maintained their baseline visual acuity after treatment. From a cohort of 528 patients [1056 eyes], 753 eyes were selected. At the beginning of the study PCP was given for one month as 0.75 to 1 g in perfusion, and then followed every 2 to 3 months. Prednisolone was also given as 0.5 mg/kg/daily and then tapered upon controlling inflammation. The mean +/- SD number of pulses was 11.5 +/- 8.5/month with follow-up of 20.6 +/- 19.8 months. Different disease activity indices such as visual acuity, posterior uveitis, retinal vasculitis, total inflammatory activity index [TIAI], total adjusted disease activity index [TADAI] were calculated at baseline and at last evaluation. The mean visual acuity improved from 2.4 to 4.4. The mean indices for posterior uveitis, retinal vasculitis, TIAI and TADAI improved from 2.2 to 1, 2.7 to 1.4, 19.3 to 9, and 27.2 to 20.5 respectively. The P value was less than 0.001 for all comparisons. Pulse cyclophosphamide is able to improve ocular lesions of Behcet's disease; therefore it may be used as a first choice, especially in retinal vasculitis