Pregnancy outcome after rituximab treatment before conception in patients affected by severe pemphigus vulgaris/superficialis

Abstract

Pregnancy is rare among patients affected by pemphigus, especially in European countries, mainly because of older patients, lower fertility rates and possible teratogenic risk.¹ Avoidance of immunosuppressive medications during pregnancy has been recommended, but inadequate treatment of pemphigus may increase morbidity and mortality.² Corticosteroids remain the first-line agent for treatment of pemphigus in pregnancy when low dosages are sufficient for disease control; however, prednisone and its metabolites crosses the placenta barrier, and high levels in the serum have been associated with adverse fetal outcomes.³

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