Evaluation of the Effects of systemic Therapy on Inflammatory Markers and Disease Severity in Patients with Pemphigus

Introduction: In recent years, various inflammatory markers that can change in inflammatory states have been investigated. On the basis of these, we thought that inflammatory markers could also be used in the follow-up of pemphigus disease and monitoring its activity. Objectives: In this study, our objective was to investigate changes in the inflammatory markers neu- trophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), lymphocyte to monocyte ratio (LMR), C-reactive protein (CRP) erythrocyte sedimentation rate (ESR), which are inflammatory markers, before treatment and during follow-up, and the correlation of dis- ease severity with these markers in patients with pemphigus receiving intravenous immunoglobulin (IVIG) and/or systemic immunosuppressant agents. Methods: Seventy-six pemphigus patients (69 had pemphigus vulgaris, 5 had pemphigus foliaceus, 2 had paraneoplastic pemphigus) who received IVIG and/or systemic immunosuppressant agents such as corticosteroids and azathioprine and used these treatments for at least 6 months were included. Changes in NLR, PLR, LMR, MPV, CRP and sedimentation values were examined in patients who received systemic treatment for at least 6 months, before the start of treatment and 3 and 6 months after the start of treatment. Results: Significant changes in inflammatory markers and correlation values were found in all patients.Conclusions: We think that neutrophil, platelet, NLR and PLR values can be used to monitor the response to treatment in pemphigus, since they show a significant decrease with treatment and are significantly positively correlated with Pemphigus Disease Area Index, which indicates the severity of the disease. LMR values were indicators of a poor prognosis. We found that the duration of remission was longer in the group receiving IVIG. Although there was no difference between the treatments in terms of disease recovery, only IVIG prolonged the duration of remission.