Third dose of injection rituximab 500 mg in patients with pemphigus vulgaris based on clinical follow-up, value of anti-desmoglein antibodies and CD-19 level: a single-center experience

Rituximab is a monoclonal antibody directed against CD20 antigens in B lymphocytes, producing selective depletion of B cells, now considered as Ist line in management of Pemphigus vulgaris. Current guideline has no consensus views on when or at what clinical severity the third dose of rituximab can be administered. Few studies, have highlighted the role of anti- desmoglein 1 & 3 antibodies (anti-dsg 1&3 Ab) and CD19 as immunobiological markers in prognosticating the relapse, remission and severity of pemphigus vulgaris. We report five cases of pemphigus treated with third dosage of rituximab 500 mg taking account of clinical symptoms, level of anti-dsg 1&3 Ab and CD19.