Case report: A novel high‐dose intravenous immunoglobulin preparation for the treatment of severe pemphigus vulgaris failing standard therapy

Pemphigus vulgaris (PV) is a severe autoimmune bullous dermatosis that is characterized by autoantibodies against epidermal adhesion proteins causing painful mucosal and skin blistering. Standard treatments for PV include corticosteroids, steroid‐sparing immunosuppressants, or intravenous monoclonal anti–CD20‐antibody therapy. The European guidelines suggest high‐dose intravenous immunoglobulin (IVIg) therapy as a promising approach for severe or treatment‐resistant cases. We report on a 65‐year‐old woman with severe and recurrent disease who achieved long‐term disease stabilization with IVIg treatment. Because of recurrent fatigue and headache, the patient was switched to an alternative IVIg preparation with a novel manufacturing process, thus ensuring high purity and better tolerability. We observed excellent efficacy, yet side effects remained largely unchanged. Further studies are necessary to evaluate the long‐term efficacy and tolerability of this new IVIg preparation.