Clinical, Laboratory and Histological Features of Dipeptidyl Peptidase-4 Inhibitor Related Noninflammatory Bullous Pemphigoid

Journal of Clinical Medicine

Ágnes Kinyó¹  Péter Oláh¹  Dalma Várszegi¹  Zsuzsanna Lengyel¹  Rolland Gyulai¹  Anita Hanyecz¹  Tímea Berki²  Endre Kálmán³  Csaba Gyömörei³ 

[1] Department of Dermatology, Venereology and Oncodermatology, University of Pécs Medical School Clinical Centre, H7632 Pécs, Hungary;Department of Immunology and Biotechnology, University of Pécs Medical School Clinical Centre, H7632 Pécs, Hungary;Department of Pathology, University of Pécs Medical School Clinical Centre, H7632 Pécs, Hungary;

关键词: bullous pemphigoid;    dipeptidyl peptidase-4 inhibitor;    DPP4;    eosinophil;    gliptin;   

DOI  :  10.3390/jcm10091916

来源: DOAJ

【 摘 要 】

Bullous pemphigoid (BP) is an autoimmune blistering disease of elderly patients that has shown increasing incidence in the last decades. Higher prevalence of BP may be due to more frequent use of provoking agents, such as antidiabetic dipeptidyl peptidase-4 inhibitor (DPP4i) drugs. Our aim was to assess DPP4i-induced bullous pemphigoid among our BP patients and characterize the clinical, laboratory and histological features of this drug-induced disease form. In our patient cohort, out of 127 BP patients (79 females (62.2%), 48 males (37.7%)), 14 (9 females and 5 males) were treated with DPP4i at the time of BP diagnosis. The Bullous Pemphigoid Disease Area Index (BPDAI) urticaria/erythema score was significantly lower, and the BPDAI damage score was significantly higher in DPP4i-BP patients compared to the nonDPP4i group. Both the mean absolute eosinophil number and the mean periblister eosinophil number was significantly lower in DPP4i-BP patients than in nonDPP4i cases (317.7 ± 0.204 vs. 894.0 ± 1.171 cells/μL, p < 0.0001; 6.75 ± 1.72 vs. 19.09 ± 3.1, p = 0.0012, respectively). Our results provide further evidence that DPP4i-associated BP differs significantly from classical BP, and presents with less distributed skin symptoms, mild erythema, normal or slightly elevated peripheral eosinophil count, and lower titers of BP180 autoantibodies. To our knowledge, this is the first case series of DPP4i-related BP with a non-inflammatory phenotype in European patients.

【 授权许可】

Unknown