{"title":"Blog","description":"","products":[{"product_id":"levels-of-alpha-1-anti-trypsin-levels-and-respiratory-functions-in-patients-with-pemphigus-vulgaris","title":"Levels of alpha 1 anti-trypsin levels and respiratory functions in patients with pemphigus vulgaris","description":"\u003cdiv class=\"WordSection1\"\u003e\n\u003cp style=\"margin-bottom: 6.0pt; text-align: right; mso-outline-level: 1;\" align=\"right\" class=\"MsoNormal\"\u003e\u003c!-- [if !mso]--\u003e\u003c\/p\u003e\n\u003ctable width=\"100%\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003c!--[endif]--\u003e\n\u003cdiv\u003e\n\u003cp class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; mso-bidi-font-size: 12.0pt;\"\u003eAttention for spellings, sentences\u003cspan style=\"mso-spacerun: yes;\"\u003e         \u003c\/span\u003eDr Tahir Kamal designation\u003c\/span\u003e\u003c\/p\u003e\n\u003cp class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; mso-bidi-font-size: 12.0pt;\"\u003eTables\/ figures not mentioned in txt.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; mso-bidi-font-size: 12.0pt;\"\u003eFigures legend text to write below figures, Tables numbering\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/div\u003e\n\u003c!-- [if !mso]--\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\n\u003cp style=\"margin-bottom: 6.0pt; text-align: right; mso-outline-level: 1;\" align=\"right\" class=\"MsoNormal\"\u003e\u003c!--[endif]--\u003e \u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 18.0pt; mso-bidi-font-size: 12.0pt; font-family: 'CG Omega','sans-serif'; color: black; mso-themecolor: text1; border: solid windowtext 1.0pt; mso-border-alt: solid windowtext .5pt; padding: 0in;\"\u003eOriginal Article\u003c\/span\u003e\u003c\/b\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 18.0pt; mso-bidi-font-size: 12.0pt; font-family: 'CG Omega','sans-serif'; color: black; mso-themecolor: text1;\"\u003e\u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 6.0pt; text-align: justify;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 20.0pt; font-family: 'CG Omega Bold'; color: black; mso-themecolor: text1;\"\u003eLevels of alpha 1 anti-trypsin levels and respiratory functions in patients with \u003ca name=\"_Hlk185773403\"\u003e\u003c\/a\u003epemphigus vulgaris \u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003ctable style=\"border-collapse: collapse; border: none; mso-yfti-tbllook: 1184; mso-table-lspace: 9.0pt; margin-left: 6.75pt; mso-table-rspace: 9.0pt; margin-right: 6.75pt; mso-table-anchor-vertical: paragraph; mso-table-anchor-horizontal: margin; mso-table-left: left; mso-table-top: 2.8pt; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-border-insideh: none; mso-border-insidev: none;\" align=\"left\" cellpadding=\"0\" cellspacing=\"0\" border=\"0\" class=\"MsoTableGrid\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"mso-yfti-irow: 0; mso-yfti-firstrow: yes;\"\u003e\n\u003ctd style=\"width: 67.5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"90\"\u003e\n\u003cp style=\"mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cb\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'CG Omega','sans-serif'; mso-bidi-font-family: 'CG Omega'; color: black; mso-themecolor: text1; mso-ansi-language: EN-IN;\" lang=\"EN-IN\"\u003e \u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cp style=\"mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cb\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'CG Omega','sans-serif'; mso-bidi-font-family: 'CG Omega'; color: black; mso-themecolor: text1; mso-ansi-language: EN-IN;\" lang=\"EN-IN\"\u003e \u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cp style=\"mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cb\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'CG Omega','sans-serif'; mso-bidi-font-family: 'CG Omega'; color: black; mso-themecolor: text1; mso-ansi-language: EN-IN;\" lang=\"EN-IN\"\u003e \u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 411.3pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"548\"\u003e\n\u003cp style=\"text-align: justify; mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eTahir Kamal, Shaiqa Mufti \u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 7.0pt; mso-bidi-font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e \u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eDepartment of Dermatology, Post Graduate Medical Institute, Ameer-ud-din Medical College, Lahore General Hospital, Lahore.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"Standard\"\u003e\u003cspan style=\"font-size: 9.0pt; mso-bidi-font-size: 10.0pt; color: black; mso-themecolor: text1; mso-bidi-language: BN;\" lang=\"EN-GB\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"mso-yfti-irow: 1; mso-yfti-lastrow: yes;\"\u003e\n\u003ctd style=\"width: 67.5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"90\"\u003e\n\u003cp style=\"mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cb\u003e\u003cspan style=\"font-family: 'CG Omega','sans-serif'; mso-bidi-font-family: 'CG Omega'; color: black; mso-themecolor: text1; mso-ansi-language: EN-IN;\" lang=\"EN-IN\"\u003eAbstract\u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 411.3pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"548\"\u003e\n\u003cp style=\"text-align: justify; mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eObjective\u003c\/span\u003e\u003c\/i\u003e\u003c\/b\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e To examine the role of alpha 1 anti-Trypsin and FEV1 in patients with pemphigus vulgaris.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 9.0pt; mso-bidi-font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e \u003c\/span\u003e\u003c\/i\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eMethods\u003c\/span\u003e\u003c\/i\u003e\u003c\/b\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e A case-control research was carried out on 10 biopsy-proven PV patients and ten age-matched healthy controls. Both groups had pulmonary function tests (FEV1, total lung capacity, vital capacity), as well as alpha 1-antitrypsin levels. The Pemphigus Disease Area Index (PDAI) was utilized to assess disease severity in the PV group. The results were examined using the One-Sample Kolmogorov-Smirnov test.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; background: white; vertical-align: baseline; mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 9.0pt; mso-bidi-font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e \u003c\/span\u003e\u003c\/i\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; background: white; vertical-align: baseline; mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eResults\u003c\/span\u003e\u003c\/i\u003e\u003c\/b\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e \u003c\/span\u003e\u003cspan style=\"font-size: 10.0pt; mso-bidi-font-size: 11.0pt; color: black; mso-themecolor: text1;\"\u003eIn the pemphigus group (60 %(N6) females, 40 % (4) males), 40 %(N4) had decreased FEV1 and 20 % (2) had reduced alpha 1 antitrypsin level. HRCT scans revealed granulomas, calcific nodules, chronic inflammation, and pleural thickening 4 patients of case group. FEV1 among cases and control compared with each other and difference was found to be significant\u0026lt;0.05). Similarly, level of Alpha 1 case and control compared and difference was found to be significant the control group [30% (N3) females, 70% (7) males] had normal pulmonary function and HRCT findings. Statistical analysis showed significant differences in both FEV1 (p\u0026lt;0.001) and alpha 1 antitrypsin level (p \u0026lt; 0.001). Disease activity in pemphigus patients was moderate in 40%, severe in 40%, and extensive in 20%. These findings indicate a potential link between pemphigus vulgaris and pulmonary abnormalities.\u003c\/span\u003e\u003cspan style=\"font-size: 8.0pt; mso-bidi-font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 8.0pt; mso-bidi-font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e \u003c\/span\u003e\u003c\/i\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eConclusion\u003c\/span\u003e\u003c\/i\u003e\u003c\/b\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e This study concludes that individuals with long-term pemphigus vulgaris may undergo lung alterations, such as a decrease in FEV1 and alpha 1-antitrypsin levels. In the therapy of PV, pulmonary involvement should be considered, especially in cases of long-term illness. Further study is required to understand the processes behind these respiratory problems.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 8.0pt; mso-bidi-font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eKey words\u003c\/span\u003e\u003c\/i\u003e\u003c\/b\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; mso-element: frame; mso-element-frame-hspace: 9.0pt; mso-element-wrap: around; mso-element-anchor-vertical: paragraph; mso-element-anchor-horizontal: margin; mso-element-top: 2.8pt; mso-height-rule: exactly;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003ePemphigus vulgaris; Pulmonary function; Alpha 1-antitrypsin, Respiratory complications; Autoimmune disorder. \u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\n\u003cp style=\"text-align: justify;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 7.0pt; mso-bidi-font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003c\/div\u003e\n\u003cp\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 8.0pt; mso-bidi-font-size: 11.0pt; font-family: 'Times New Roman','serif'; mso-fareast-font-family: 'Times New Roman'; color: black; mso-themecolor: text1; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;\"\u003e\u003cbr style=\"page-break-before: auto; mso-break-type: section-break;\" clear=\"all\"\u003e\u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cdiv class=\"WordSection2\"\u003e\n\u003cp style=\"margin-top: 0in; text-align: justify;\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 11.0pt; color: black; mso-themecolor: text1; background: white;\"\u003eIntroduction\u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 12.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eThe skin and mucous membranes are affected by the rare autoimmune bullous disorders known as pemphigus diseases. In central Europe, their \u003c\/span\u003e \u003c!-- [if !mso]--\u003e\u003c\/p\u003e\n\u003ctable width=\"100%\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd\u003e\n\u003c!--[endif]--\u003e\n\u003cdiv\u003e\n\u003cdiv style=\"mso-element: para-border-div; border: none; border-top: solid windowtext 1.0pt; mso-border-top-alt: solid windowtext .5pt; padding: 1.0pt 0in 0in 0in;\"\u003e\n\u003cp style=\"margin-bottom: 6.0pt; mso-add-space: auto; text-align: justify; tab-stops: 175.5pt; border: none; mso-border-top-alt: solid windowtext .5pt; padding: 0in; mso-padding-alt: 1.0pt 0in 0in 0in;\" class=\"MsoNormalCxSpFirst\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt;\"\u003eManuscript: \u003c\/span\u003e\u003c\/i\u003e\u003c\/b\u003e\u003cspan style=\"font-size: 10.0pt;\"\u003eReceived on: November 27, 2024\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/div\u003e\n\u003cp style=\"margin-bottom: 6.0pt; mso-add-space: auto; tab-stops: .75in 58.5pt 175.5pt;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt;\"\u003eAccepted on: December 19, 2024\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 6.0pt; mso-add-space: auto; tab-stops: 175.5pt;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt;\"\u003eAddress for correspondence\u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 6.0pt; mso-add-space: auto;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt;\"\u003eDr. Tahir Kamal\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 6.0pt; mso-add-space: auto;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt;\"\u003eDepartment of Dermatology, \u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 6.0pt; mso-add-space: auto;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt;\"\u003ePGMI\/AMC\/Lahore General Hospital, Lahore.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 6.0pt; mso-add-space: auto;\" class=\"MsoNormalCxSpLast\"\u003e\u003cspan style=\"font-size: 10.0pt;\"\u003eEmail: skinlifeclinic8833@gmail.com\u003c\/span\u003e\u003cspan style=\"font-size: 10.0pt; mso-bidi-font-size: 12.0pt; mso-ansi-language: FR;\" lang=\"FR\"\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/div\u003e\n\u003c!-- [if !mso]--\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\n\u003cp style=\"margin-bottom: 12.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003c!--[endif]--\u003e \u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eestimated incidence is two new cases per million people each year. They exhibit chronic evolution, considerable morbidity and death, as well as a severe reduction in life quality.\u003csup\u003e1\u003c\/sup\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 12.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eThey are caused by the generation of pathogenic autoantibodies (typically of the IgG type) directed against various desmosome proteins (desmogleins). The binding of these autoantibodies to desmosome components impairs intra-Epidermal adhesion, resulting in acantholysis and the production of vesicles, blisters, and erosions on the skin and\/or mucous membranes.\u003csup\u003e2\u003c\/sup\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 12.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eBased on clinical and histological characteristics, as well as the specific antigens against which auto-antibodies are created, different kinds of pemphigus have been identified. The most common types include PV is an autoimmune bullous illness in which auto-antibodies against desmosomal adhesion complex molecules disrupt desmosomal function, resulting in intercellular adhesion abnormalities in the skin, oral, and vaginal mucosa. The inactivation of the desmosomal cadherin desmoglein 3 (DSG3) is critical in the patho-physiology of PV.\u003csup\u003e3\u003c\/sup\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 12.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eThe use of steroids in the treatment of PV was innovative, resulting in a significant decrease in mortality. During the course of the disease, the most prevalent causes of mortality were septicemia and lung infection, among others. However, combining steroids with adjuvant medicines reduced steroid-related morbidity. According to Olszewska et al., cyclophosphamide at a dose of 1.1-1.5 mg\/kg\/day is an adjuvant medication of choice in the treatment of moderate-to-severe PV.\u003csup\u003e4\u003c\/sup\u003e Furthermore, rituximab, a chimeric monoclonal antibody targeting CD20, has been shown to be beneficial in refractory situations where widely accepted methods are either ineffective or not viable due to adverse effects.\u003csup\u003e5\u003c\/sup\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 12.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eThe role of the respiratory tract in paraneoplastic pemphigus has been thoroughly explored, although evidence on pulmonary function in PV is lacking. The current study aims to assess the respiratory function of patients with severe, long-standing PV prior to treatment, as well as to quantify alpha 1-antitrypsin (1-AT) serum levels, in order to identify potential risk factors for lung damage in pemphigus vulgaris patients.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 12.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003ePatients and methods\u003c\/span\u003e\u003c\/b\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003e\u003cspan style=\"mso-spacerun: yes;\"\u003e  \u003c\/span\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003c\/b\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 12.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003e\u003cspan style=\"mso-spacerun: yes;\"\u003e \u003c\/span\u003eThe institutional Ethical Committee approved this case control study, and patients and controls provided written informed consent. Ten biopsy-proven moderate to severe pemphigus vulgaris patients and ten age-matched controls were enrolled, and data was gathered over a 6-month period on predesigned Performa.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 12.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eThe study included ten patients, four females and six males, who had a positive tzanck test for acantholytic cells with flaccid vesicles and erosions and were hospitalized to the Dermatology Department at Lahore General Hospital. There were no concurrent autoimmune diseases, cardiac or renal abnormalities, or a history of asthma or allergies in the research group.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 12.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eThe study excluded pregnant and breastfeeding women, known smokers, individuals with hereditary alpha 1 deficiency, and patients with a history of tuberculosis or connective tissue illnesses. All of the patients had severe oral lesions. All of the participants in the research had pemphigus vulgaris for more than five years.\u003cspan style=\"mso-spacerun: yes;\"\u003e  \u003c\/span\u003ePulmonary function tests and alpha 1 antitrypsin level were done on both the study and control groups.\u003cspan style=\"mso-spacerun: yes;\"\u003e  \u003c\/span\u003eThe assessment of total lung capacity, vital capacity, and FEV1 was done by pulmonary function testing.\u003cspan style=\"mso-spacerun: yes;\"\u003e  \u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 12.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eThe sick group and the healthy controls' values were compared using the One-Sample Kolmogorov-Smirnov test. P-value (p) was evaluated using SPSS.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 12.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eResults \u003c\/span\u003e\u003c\/b\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003e\u003cspan style=\"mso-spacerun: yes;\"\u003e \u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 12.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eAnthropometric traits, lifestyle choices, and physical activity levels were essentially comparable between groups (Figure 1). Out of 10 study participants in case Group showed 6 women and 4 men with ages ranging from 28 to 50, there was a decrease in FEV1 in 4 of the participants, while there was a decrease in alpha 1 antitrypsin in 2 of the participants.\u003c\/span\u003e \u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eWhile none of the patients in the control group displayed a decrease in alpha 1 antitrypsin level, two patients' levels were reduced when alpha 1 antitrypsin was quantified.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; text-align: center; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" align=\"center\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white; mso-no-proof: yes;\"\u003e \u003c\/span\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eFigure 1 \u003c\/span\u003e\u003c\/b\u003eAnthropometric traits and lifestyle comparison between groups, place in results section.\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003e\u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eAnthropometric traits, lifestyle choices, and physical activity levels were essentially comparable between groups. Table provides a summary of our findings. Alpha 1 Antitrypsin level was lowered in two patients out of ten pemphigus patients, while significant change was seen in Fev1 in four out of ten pemphigus patients to control to be wither. One patient's HRCT revealed a granuloma in the apico-posterior section of the left upper lobe. One patient had a calcific lung nodule in the right upper lobe, whereas the other two had chronic inflammatory alterations. Another study participant had bilateral epical pleural thickening. These changes support our idea that pulmonary diseases can emerge in pemphigus vulgaris patients. The control group had 3 females and 7 males with an age range of thirty to fifty years all of them showed normal alpha 1 antitrypsin level, normal lung functions and their HRCT chest also turned out to be normal.\u003cspan style=\"mso-spacerun: yes;\"\u003e  \u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 10.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eThe two group were assessed i.e. cases of pemphigus vulgaries and age matched healthy control, for mean value of FEV1 and Alpha1 Antitrypsin. The mean values of FEV1 were calculated in both groups in liters per minute and independent samples t-test applied for the significance among cases and controls, turned out to be 0.0017 i.e. \u0026lt;0.05. The demographic and clinical characteristics of cases and controls are summarized in Table 1. For Alpha1 Anti trypsin the mean values among cases and controls compared with each other applying same independent samples t-test found to 0.001 i.e. \u0026lt;0.05.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003eTable 1 \u003c\/span\u003e\u003c\/b\u003eCharacteristics summary of cases and controls, place after patient demographics.\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e\u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003ctable style=\"width: 220.5pt; margin-left: -.05in; border-collapse: collapse; border: none; mso-yfti-tbllook: 1184; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-border-insideh: none; mso-border-insidev: none;\" width=\"294\" cellpadding=\"0\" cellspacing=\"0\" border=\"0\" class=\"MsoTableGrid\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"mso-yfti-irow: 0; mso-yfti-firstrow: yes; mso-yfti-lastrow: yes;\"\u003e\n\u003ctd style=\"width: 220.5pt; border-top: solid windowtext 1.0pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"294\"\u003e\n\u003cp style=\"mso-add-space: auto; text-align: justify; mso-pagination: none; tab-stops: 81.0pt 94.5pt 2.0in 148.5pt 193.5pt 2.75in; mso-layout-grid-align: none; text-autospace: none; margin: 0in -.9pt .0001pt -5.4pt;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e\u003cspan style=\"mso-tab-count: 1;\"\u003e                                      \u003c\/span\u003e\u003cspan style=\"mso-spacerun: yes;\"\u003e  \u003c\/span\u003eCases\u003cspan style=\"mso-spacerun: yes;\"\u003e             \u003c\/span\u003eControls\u003cspan style=\"mso-spacerun: yes;\"\u003e    \u003c\/span\u003eTotal\u003cspan style=\"background: white;\"\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/i\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\n\u003cp style=\"margin-left: -.05in; mso-add-space: auto; mso-pagination: none; tab-stops: 81.0pt 91.8pt 2.0in 146.85pt 193.5pt 201.95pt; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eAge\u003cspan style=\"mso-tab-count: 3;\"\u003e                                                           \u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-left: 4.5pt; mso-add-space: auto; mso-pagination: none; tab-stops: 81.0pt 91.8pt 2.0in 146.85pt 193.5pt 201.95pt; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e≤ 50 years\u003cspan style=\"background: white;\"\u003e\u003cspan style=\"mso-tab-count: 1;\"\u003e               \u003c\/span\u003e\u003c\/span\u003e3 (75%)\u003cspan style=\"background: white;\"\u003e\u003cspan style=\"mso-tab-count: 1;\"\u003e              \u003c\/span\u003e\u003c\/span\u003e1 (25%)\u003cspan style=\"background: white;\"\u003e\u003cspan style=\"mso-tab-count: 1;\"\u003e        \u003c\/span\u003e\u003c\/span\u003e4\u003cspan style=\"background: white;\"\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-left: 4.5pt; mso-add-space: auto; mso-pagination: none; tab-stops: 81.0pt 91.8pt 2.0in 146.85pt 193.5pt 201.95pt; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e≥50 years\u003cspan style=\"background: white;\"\u003e\u003cspan style=\"mso-tab-count: 1;\"\u003e                \u003c\/span\u003e\u003c\/span\u003e7 (43.8%)\u003cspan style=\"background: white;\"\u003e\u003cspan style=\"mso-tab-count: 1;\"\u003e          \u003c\/span\u003e\u003c\/span\u003e9 (56.3%)\u003cspan style=\"background: white;\"\u003e\u003cspan style=\"mso-tab-count: 1;\"\u003e    \u003c\/span\u003e\u003c\/span\u003e16\u003cspan style=\"background: white;\"\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-left: -4.5pt; mso-add-space: auto; mso-pagination: none; tab-stops: 81.0pt 91.8pt 2.0in 146.85pt 193.5pt 201.95pt; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003eSex\u003cspan style=\"mso-tab-count: 3;\"\u003e                                                           \u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-left: 4.5pt; mso-add-space: auto; mso-pagination: none; tab-stops: 81.0pt 91.8pt 2.0in 146.85pt 193.5pt 201.95pt; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eFemales\u003cspan style=\"background: white;\"\u003e\u003cspan style=\"mso-tab-count: 1;\"\u003e                   \u003c\/span\u003e\u003c\/span\u003e6 (66.7%)\u003cspan style=\"background: white;\"\u003e\u003cspan style=\"mso-tab-count: 1;\"\u003e          \u003c\/span\u003e\u003c\/span\u003e3 (33.3%)\u003cspan style=\"background: white;\"\u003e\u003cspan style=\"mso-tab-count: 1;\"\u003e    \u003c\/span\u003e\u003c\/span\u003e9\u003cspan style=\"background: white;\"\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-left: 4.5pt; mso-add-space: auto; mso-pagination: none; tab-stops: 81.0pt 91.8pt 2.0in 146.85pt 193.5pt 201.95pt; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eMales\u003cspan style=\"mso-tab-count: 1;\"\u003e                       \u003c\/span\u003e4 (36.4%)\u003cspan style=\"mso-tab-count: 1;\"\u003e          \u003c\/span\u003e7 (63.6%)\u003cspan style=\"mso-tab-count: 1;\"\u003e    \u003c\/span\u003e11\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-left: -4.5pt; mso-add-space: auto; mso-pagination: none; tab-stops: 81.0pt 91.8pt 2.0in 146.85pt 193.5pt 201.95pt; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eOther diseases\u003cspan style=\"mso-tab-count: 3;\"\u003e                                        \u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-left: 4.5pt; mso-add-space: auto; mso-pagination: none; tab-stops: 81.0pt 91.8pt 2.0in 146.85pt 193.5pt 201.95pt; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eHypertension\u003cspan style=\"mso-tab-count: 1;\"\u003e          \u003c\/span\u003e2 (40%)\u003cspan style=\"mso-tab-count: 1;\"\u003e              \u003c\/span\u003e3 (60%)\u003cspan style=\"mso-tab-count: 1;\"\u003e        \u003c\/span\u003e5\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-left: 4.5pt; mso-add-space: auto; mso-pagination: none; tab-stops: 81.0pt 91.8pt 2.0in 146.85pt 193.5pt 201.95pt; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eDuodenal ulcer\u003cspan style=\"mso-tab-count: 1;\"\u003e       \u003c\/span\u003e1 (100%)\u003cspan style=\"mso-tab-count: 1;\"\u003e           \u003c\/span\u003eNil\u003cspan style=\"mso-tab-count: 1;\"\u003e                 \u003c\/span\u003e1\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-left: 4.5pt; mso-add-space: auto; mso-pagination: none; tab-stops: 81.0pt 91.8pt 2.0in 146.85pt 193.5pt 201.95pt; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eHistory of pleurisy\u003cspan style=\"mso-tab-count: 1;\"\u003e \u003c\/span\u003e2 (100%)\u003cspan style=\"mso-tab-count: 1;\"\u003e           \u003c\/span\u003eNil\u003cspan style=\"mso-tab-count: 1;\"\u003e                 \u003c\/span\u003e2\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-left: 4.5pt; mso-add-space: auto; mso-pagination: none; tab-stops: 81.0pt 91.8pt 2.0in 146.85pt 193.5pt 201.95pt; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003ePulmonary disease\u003cspan style=\"mso-tab-count: 1;\"\u003e     \u003c\/span\u003e1 (100%)\u003cspan style=\"mso-tab-count: 1;\"\u003e       \u003c\/span\u003eNil\u003cspan style=\"mso-tab-count: 1;\"\u003e                 \u003c\/span\u003e1\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-left: 4.5pt; mso-add-space: auto; mso-pagination: none; tab-stops: 81.0pt 91.8pt 2.0in 146.85pt 193.5pt 201.95pt; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eRenal lithiasis\u003cspan style=\"mso-tab-count: 1;\"\u003e         \u003c\/span\u003e1 (100%)\u003cspan style=\"mso-tab-count: 1;\"\u003e           \u003c\/span\u003eNil\u003cspan style=\"mso-tab-count: 1;\"\u003e                 \u003c\/span\u003e1\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-left: 4.5pt; mso-add-space: auto; mso-pagination: none; tab-stops: 81.0pt 91.8pt 2.0in 146.85pt 193.5pt 201.95pt; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eSeasonal rhinitis\u003cspan style=\"mso-tab-count: 1;\"\u003e     \u003c\/span\u003e1 (100%)\u003cspan style=\"mso-tab-count: 1;\"\u003e           \u003c\/span\u003eNil\u003cspan style=\"mso-tab-count: 1;\"\u003e                 \u003c\/span\u003e1\u003c\/span\u003e\u003c\/p\u003e\n\u003cdiv style=\"mso-element: para-border-div; border: none; border-bottom: solid windowtext 1.0pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 0in 1.0pt 0in; margin-left: -4.5pt; margin-right: 4.5pt;\"\u003e\n\u003cp style=\"mso-pagination: none; tab-stops: 81.0pt 91.8pt 2.0in 146.85pt 193.5pt 201.95pt; mso-layout-grid-align: none; text-autospace: none; border: none; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in; mso-padding-alt: 0in 0in 1.0pt 0in;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e\u003cspan style=\"mso-spacerun: yes;\"\u003e    \u003c\/span\u003eNone\u003cspan style=\"mso-tab-count: 1;\"\u003e                        \u003c\/span\u003e2 (22.2%)\u003cspan style=\"mso-tab-count: 1;\"\u003e          \u003c\/span\u003e7 (77.8%)\u003cspan style=\"mso-tab-count: 1;\"\u003e    \u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/div\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 11.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-bottom: 12.0pt; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003ePemphigus disease activity is noted in study group using the pemphigus disease area index which includes the following proformas. This scoring system includes a score ranging from 0-263, which comprises of 250 points representing disease activity and 120 points for skin activity 10 points for scalp activity and 120 points for mucosal activity.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"mso-add-space: auto; text-align: justify; line-height: 110%; margin: 0in 0in 12.0pt 0in;\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 110%; color: black; mso-themecolor: text1; background: white;\"\u003eExtent of disease according to PDAI\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"mso-add-space: auto; text-align: justify; line-height: 110%; tab-stops: 63.0pt; margin: 0in 0in 12.0pt 0in;\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 110%; color: black; mso-themecolor: text1; background: white;\"\u003eModerate\u003cspan style=\"mso-tab-count: 1;\"\u003e      \u003c\/span\u003e0-15 points\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"mso-add-space: auto; text-align: justify; line-height: 110%; tab-stops: 63.0pt; margin: 0in 0in 12.0pt 0in;\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 110%; color: black; mso-themecolor: text1; background: white;\"\u003eSignificant\u003cspan style=\"mso-tab-count: 1;\"\u003e    \u003c\/span\u003e15-45 points\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"mso-add-space: auto; text-align: justify; line-height: 110%; tab-stops: 63.0pt; margin: 0in 0in 12.0pt 0in;\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 110%; color: black; mso-themecolor: text1; background: white;\"\u003eExtensive\u003cspan style=\"mso-tab-count: 1;\"\u003e      \u003c\/span\u003e\u0026gt;45 points\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin: 0in; margin-bottom: .0001pt; mso-add-space: auto; text-align: justify;\"\u003e\u003cspan style=\"font-size: 11.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"margin-top: 0in; text-align: justify;\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 11.0pt; color: black; mso-themecolor: text1; background: white;\"\u003eDiscussion\u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cp style=\"mso-margin-top-alt: auto; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eIn our study 40% Pemphigus vulgaris patients had lung changes including infections while in a study of Belgnaoui, et al, 68% had lung changes with infections. Our results are comparable and small differences between two studies may due to differences in severity of disease and duration of hospitalization. Pulmonary findings, including granulomas and pleural thickening, are illustrated in Figure 2. The study by Ljubojevic S et al. on 159 PV Patients, during 19 years revealed several complications associated with high doses of corticosteroids and immunosuppressive\u003cbr style=\"mso-special-character: line-break;\"\u003e\u003c!-- [if !supportLineBreakNewLine]--\u003e\u003cbr style=\"mso-special-character: line-break;\"\u003e\u003c!--[endif]--\u003e\u003c\/span\u003e\u003cspan style=\"font-size: 6.0pt; mso-bidi-font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003eTable 2 \u003c\/span\u003e\u003c\/b\u003ePDAI scoring and disease activity, place in results section.\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e\u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003ctable style=\"border-collapse: collapse; border: none; mso-yfti-tbllook: 1184; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-border-insideh: none; mso-border-insidev: none;\" cellpadding=\"0\" cellspacing=\"0\" border=\"0\" class=\"MsoTableGrid\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"mso-yfti-irow: 0; mso-yfti-firstrow: yes;\"\u003e\n\u003ctd style=\"width: 113.4pt; border-top: solid windowtext 1.0pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"151\"\u003e\n\u003cp class=\"MsoNormal\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003ePDAI\u003c\/span\u003e\u003c\/i\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 113.4pt; border-top: solid windowtext 1.0pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"151\"\u003e\n\u003cp style=\"text-align: center;\" align=\"center\" class=\"MsoNormal\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003ePatient number in \u003c\/span\u003e\u003c\/i\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: center;\" align=\"center\" class=\"MsoNormal\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003estudy group\u003c\/span\u003e\u003c\/i\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"mso-yfti-irow: 1;\"\u003e\n\u003ctd style=\"width: 113.4pt; border: none; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"151\"\u003e\n\u003cp class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eModerate\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 113.4pt; border: none; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"151\"\u003e\n\u003cp style=\"text-align: center;\" align=\"center\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e4\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"mso-yfti-irow: 2;\"\u003e\n\u003ctd style=\"width: 113.4pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"151\"\u003e\n\u003cp class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eSevere\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 113.4pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"151\"\u003e\n\u003cp style=\"text-align: center;\" align=\"center\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e4\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"mso-yfti-irow: 3; mso-yfti-lastrow: yes;\"\u003e\n\u003ctd style=\"width: 113.4pt; border: none; border-bottom: solid windowtext 1.0pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"151\"\u003e\n\u003cp class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eExtensive\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 113.4pt; border: none; border-bottom: solid windowtext 1.0pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"151\"\u003e\n\u003cp style=\"text-align: center;\" align=\"center\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e2\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white; mso-no-proof: yes;\"\u003e \u003c\/span\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormalCxSpMiddle\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003eFigure 2 \u003c\/span\u003e\u003c\/b\u003ePulmonary findings in patients, place in discussion section.\u003cspan style=\"mso-spacerun: yes;\"\u003e            \u003c\/span\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003eTable 3\u003c\/span\u003e\u003c\/b\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e Results table of independent samples t-test.\u003c\/span\u003e\u003c\/p\u003e\n\u003ctable style=\"margin-left: 5.4pt; border-collapse: collapse; border: none; mso-yfti-tbllook: 1184; mso-padding-alt: 0in 5.4pt 0in 5.4pt; mso-border-insideh: none; mso-border-insidev: none;\" cellpadding=\"0\" cellspacing=\"0\" border=\"0\" class=\"MsoTableGrid\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"mso-yfti-irow: 0; mso-yfti-firstrow: yes;\"\u003e\n\u003ctd style=\"width: 63.9pt; border-top: solid windowtext 1.0pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"85\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eGroups\u003cspan style=\"background: white;\"\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/i\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 27.55pt; border-top: solid windowtext 1.0pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"37\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eN\u003cspan style=\"background: white;\"\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/i\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 40.5pt; border-top: solid windowtext 1.0pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"54\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eMean\u003cspan style=\"background: white;\"\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/i\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 40.5pt; border-top: solid windowtext 1.0pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"54\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eSD\u003cspan style=\"background: white;\"\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/i\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 45.4pt; border-top: solid windowtext 1.0pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; mso-border-top-alt: solid windowtext .5pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"61\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eP-value\u003cspan style=\"background: white;\"\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/i\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"mso-yfti-irow: 1;\"\u003e\n\u003ctd style=\"width: 63.9pt; border: none; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"85\"\u003e\n\u003cp style=\"margin-left: -.9pt; text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eFev1 \u003cspan style=\"background: white;\"\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 27.55pt; border: none; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"37\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 40.5pt; border: none; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"54\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 40.5pt; border: none; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"54\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 45.4pt; border: none; mso-border-top-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"61\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"mso-yfti-irow: 2;\"\u003e\n\u003ctd style=\"width: 63.9pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"85\"\u003e\n\u003cp style=\"margin-left: .05in; text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eCases\u003cspan style=\"background: white;\"\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 27.55pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"37\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e10\u003cspan style=\"background: white;\"\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 40.5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"54\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; mso-fareast-font-family: Calibri; color: black; mso-themecolor: text1;\"\u003e1.54\u003c\/span\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 40.5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"54\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; mso-fareast-font-family: Calibri; color: black; mso-themecolor: text1;\"\u003e±0.53\u003c\/span\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 45.4pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"61\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; mso-fareast-font-family: Calibri; color: black; mso-themecolor: text1;\"\u003e0.0017\u003c\/span\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"mso-yfti-irow: 3;\"\u003e\n\u003ctd style=\"width: 63.9pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"85\"\u003e\n\u003cp style=\"margin-left: .05in; text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eControls\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 27.55pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"37\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e10\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 40.5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"54\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; mso-fareast-font-family: Calibri; color: black; mso-themecolor: text1;\"\u003e2.50\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 40.5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"54\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; mso-fareast-font-family: Calibri; color: black; mso-themecolor: text1;\"\u003e±0.20\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 45.4pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"61\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"mso-yfti-irow: 4;\"\u003e\n\u003ctd style=\"width: 217.85pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" colspan=\"5\" width=\"290\"\u003e\n\u003cp style=\"margin-left: -.9pt; text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eAlpha 1 anti-trypsin levels \u003cspan style=\"background: white;\"\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"mso-yfti-irow: 5;\"\u003e\n\u003ctd style=\"width: 63.9pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"85\"\u003e\n\u003cp style=\"margin-left: .05in; text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eCases\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 27.55pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"37\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e10\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 40.5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"54\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; mso-fareast-font-family: Calibri; color: black; mso-themecolor: text1;\"\u003e95.00\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 40.5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"54\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; mso-fareast-font-family: Calibri; color: black; mso-themecolor: text1;\"\u003e±17.09\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 45.4pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"61\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; mso-fareast-font-family: Calibri; color: black; mso-themecolor: text1;\"\u003e0.001\u003c\/span\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003ctr style=\"mso-yfti-irow: 6; mso-yfti-lastrow: yes;\"\u003e\n\u003ctd style=\"width: 63.9pt; border: none; border-bottom: solid windowtext 1.0pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"85\"\u003e\n\u003cp style=\"margin-left: .05in; text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eControls\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 27.55pt; border: none; border-bottom: solid windowtext 1.0pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"37\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e10\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 40.5pt; border: none; border-bottom: solid windowtext 1.0pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"54\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; mso-fareast-font-family: Calibri; color: black; mso-themecolor: text1;\"\u003e190.0\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 40.5pt; border: none; border-bottom: solid windowtext 1.0pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" valign=\"top\" width=\"54\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; mso-fareast-font-family: Calibri; color: black; mso-themecolor: text1;\"\u003e±27.23\u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003ctd style=\"width: 45.4pt; border: none; border-bottom: solid windowtext 1.0pt; mso-border-bottom-alt: solid windowtext .5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"61\"\u003e\n\u003cp style=\"text-align: justify; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003c\/td\u003e\n\u003c\/tr\u003e\n\u003c\/tbody\u003e\n\u003c\/table\u003e\n\u003cp style=\"mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003etherapy, including Skin infections in 16.35%, sepsis in 5.66% and 14 patients (8.81%) died during the period of hospitalization. The absence of sepsis and death in our study may be due to small number of patients with severe PV and shorter period of our study.\u003csup\u003e6\u003c\/sup\u003e\u003cspan style=\"mso-spacerun: yes;\"\u003e  \u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eThe extent of disease severity, as assessed using the PDAI scoring system, is detailed in Table 2.\u003c\/span\u003e \u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003ePemphigus vulgaris affects stratified squamous epithelium. So far, there are no clinical trials evaluating possible factors that could enhance susceptibility of PV patients to pulmonary infections. Upper and lower respiratory epithelial cells express all the planking antigens. Specifically paraneoplastic pemphigus is classically related to bronchiolitis obliterans. However, there is no evidence that antibodies against desmogliens play any part in the induction of respiratory lesions. These results coherent with the study conducted by Nguyen VT in 2001.\u003csup\u003e7\u003c\/sup\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eThe results of the independent samples t-test for FEV1 and alpha 1 antitrypsin level are presented in Table 3. In our study, patients in study group with age above 50 were 7 and in control group age above 50 were 9. 14 were female patients in total, both Pemphigus and control group i.e.70 percent and 6 Male in total i.e. 30 percent.\u003cspan style=\"mso-spacerun: yes;\"\u003e  \u003c\/span\u003eFev1 in Pemphigus group was found to be reduced, 4 patients, 3 females and 1 Male with mean 1.54 liters SD ±0.53 and in control group all cases had FEV1 within normal range with mean value of 2.5 liters ±0.20 after applying independent t-test on both groups P value calculated P \u0026lt;0.0017. Alpha 1 Antitrypsin levels were found to be reduced in 2 patients in study group with mean of 95.0±17.09 and in control group was 190.0±27.23. P\u0026lt;0.001 showing significant difference It is believed that insufficient production, or prolonged consumption of Alpha 1 might predispose these patients for lung infection and for chronic obstructive lung disease. These results are coherent with the study conducted by Holme J, Stockley Rain 2007.\u003csup\u003e8\u003c\/sup\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eAccording to studies, the rise of anti-proteases like 1-AT causes the proteolytic activity of blister fluid in PV to gradually diminish. According to recent study, matrix metalloproteinase-9 (MMP-9) in skin tissue is inhibited by 1-AT and 1 antichymotrypsin. MMP-9 is reported to be over expressed in experimental PV models. Blister formation in PV may be influenced by an imbalance in the concentrations of MMP-9 and 1-AT. These results are coherent with our results.\u003csup\u003e9\u003c\/sup\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eConclusion\u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cp style=\"mso-margin-top-alt: auto; mso-margin-bottom-alt: auto; text-align: justify; line-height: 115%; mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eThis study concludes that lung changes do occur in cases of pemphigus vulgaris with longer duration along with reduction in FEV1 and alpha 1 antitrypsin level in a significant manner.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; margin: 6.0pt 0in 6.0pt 0in;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003eDeclaration of patient consent \u003c\/span\u003e\u003c\/i\u003e\u003c\/b\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003ethe authors certify that they have obtained all appropriate patient consent.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; margin: 6.0pt 0in 6.0pt 0in;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003eFinancial support and sponsorship\u003c\/span\u003e\u003c\/i\u003e\u003c\/b\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e None.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; margin: 6.0pt 0in 6.0pt 0in;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003eConflict of interest\u003c\/span\u003e\u003c\/i\u003e\u003c\/b\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; background: white;\"\u003e Authors declared no conflict of interest.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; line-height: 115%; margin: 6.0pt 0in 6.0pt 0in;\" class=\"MsoNormal\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003ci style=\"mso-bidi-font-style: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eAuthors’ contribution\u003c\/span\u003e\u003c\/i\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; line-height: 115%; margin: 6.0pt 0in 6.0pt 0in;\" class=\"p\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eTK\u003c\/span\u003e\u003c\/b\u003e\u003cspan style=\"font-size: 10.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003e: Substantial contribution to conception and study design, acquisition of data, manuscript writing, has given final approval of the version of the manuscript to be published.\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; line-height: 115%; margin: 6.0pt 0in 6.0pt 0in;\" class=\"p\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 10.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003eSM\u003c\/span\u003e\u003c\/b\u003e\u003cspan style=\"font-size: 10.0pt; line-height: 115%; color: black; mso-themecolor: text1; background: white;\"\u003e: Substantial contribution to analysis and interpretation of data, critical review of the manuscript, has given final approval of the version of the manuscript to be published.\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003c\/b\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; line-height: 115%;\" class=\"p\"\u003e\u003cb style=\"mso-bidi-font-weight: normal;\"\u003e\u003cspan style=\"font-size: 11.0pt; line-height: 115%; color: black; mso-themecolor: text1;\"\u003eReferences\u003c\/span\u003e\u003c\/b\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; text-indent: -.25in; mso-list: l0 level1 lfo1;\" class=\"MsoListParagraphCxSpFirst\"\u003e\u003c!-- [if !supportLists]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e\u003cspan style=\"mso-list: Ignore;\"\u003e1.\u003cspan style=\"font: 7.0pt 'Times New Roman';\"\u003e       \u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c!--[endif]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eKridin K, Sagi SZ, Bergman R. Mortality and cause of death in patients with pemphigus. Acta dermato-venereologica. 2017;97(5):607-11.\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; text-indent: -.25in; mso-list: l0 level1 lfo1;\" class=\"MsoListParagraphCxSpMiddle\"\u003e\u003c!-- [if !supportLists]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e\u003cspan style=\"mso-list: Ignore;\"\u003e2.\u003cspan style=\"font: 7.0pt 'Times New Roman';\"\u003e       \u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c!--[endif]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eDi Zenzo G, Amber KT, Sayar BS, Müller EJ, Borradori L, editors. Immune response in pemphigus and beyond: progresses and emerging concepts. Seminars in immunopathology; 2016: Springer.\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; text-indent: -.25in; mso-list: l0 level1 lfo1;\" class=\"MsoListParagraphCxSpMiddle\"\u003e\u003c!-- [if !supportLists]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e\u003cspan style=\"mso-list: Ignore;\"\u003e3.\u003cspan style=\"font: 7.0pt 'Times New Roman';\"\u003e       \u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c!--[endif]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eMüller R, Svoboda V, Wenzel E, Müller HH, Hertl M. IgG against extracellular subdomains of desmoglein 3 relates to clinical phenotype of pemphigus vulgaris. Experimental dermatology. 2008;17(1):35-43.\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; text-indent: -.25in; mso-list: l0 level1 lfo1;\" class=\"MsoListParagraphCxSpMiddle\"\u003e\u003c!-- [if !supportLists]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e\u003cspan style=\"mso-list: Ignore;\"\u003e4.\u003cspan style=\"font: 7.0pt 'Times New Roman';\"\u003e       \u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c!--[endif]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eOlszewska M, Kolacinska-Strasz Z, Sulej J, Labecka H, Cwikla J, Natorska U, et al. Efficacy and safety of cyclophosphamide, azathioprine, and cyclosporine (ciclosporin) as adjuvant drugs in pemphigus vulgaris. American journal of clinical dermatology. 2007; 8:85-92.\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; text-indent: -.25in; mso-list: l0 level1 lfo1;\" class=\"MsoListParagraphCxSpMiddle\"\u003e\u003c!-- [if !supportLists]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e\u003cspan style=\"mso-list: Ignore;\"\u003e5.\u003cspan style=\"font: 7.0pt 'Times New Roman';\"\u003e       \u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c!--[endif]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eStrowd LC, Taylor SL, Jorizzo JL, Namazi MR. Therapeutic ladder for pemphigus vulgaris: emphasis on achieving complete remission. Journal of the American Academy of Dermatology. 2011;64(3):490-4.\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; text-indent: -.25in; mso-list: l0 level1 lfo1;\" class=\"MsoListParagraphCxSpMiddle\"\u003e\u003c!-- [if !supportLists]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e\u003cspan style=\"mso-list: Ignore;\"\u003e6.\u003cspan style=\"font: 7.0pt 'Times New Roman';\"\u003e       \u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c!--[endif]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eLjubojevic S, Lipozenčić J. Autoimmune bullous diseases associations. Clinics in dermatology. 2012;30(1):17-33.\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; text-indent: -.25in; mso-list: l0 level1 lfo1;\" class=\"MsoListParagraphCxSpMiddle\"\u003e\u003c!-- [if !supportLists]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e\u003cspan style=\"mso-list: Ignore;\"\u003e7.\u003cspan style=\"font: 7.0pt 'Times New Roman';\"\u003e       \u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c!--[endif]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eNguyen VT, Ndoye A, Bassler KD, Shultz LD, Shields MC, Ruben BS, et al. Classification, clinical manifestations, and immunopathological mechanisms of the epithelial variant of paraneoplastic autoimmune multiorgan syndrome: a reappraisal of paraneoplastic pemphigus. Archives of Dermatology. 2001;137(2):193-206.\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; text-indent: -.25in; mso-list: l0 level1 lfo1;\" class=\"MsoListParagraphCxSpMiddle\"\u003e\u003c!-- [if !supportLists]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e\u003cspan style=\"mso-list: Ignore;\"\u003e8.\u003cspan style=\"font: 7.0pt 'Times New Roman';\"\u003e       \u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c!--[endif]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eHolme J, Stockley RA. Radiologic and clinical features of COPD patients with discordant pulmonary physiology: lessons from α1-antitrypsin deficiency. Chest. 2007;132(3):909-15.\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify; text-indent: -.25in; mso-list: l0 level1 lfo1;\" class=\"MsoListParagraphCxSpLast\"\u003e\u003c!-- [if !supportLists]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e\u003cspan style=\"mso-list: Ignore;\"\u003e9.\u003cspan style=\"font: 7.0pt 'Times New Roman';\"\u003e       \u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c\/span\u003e\u003c!--[endif]--\u003e\u003cspan class=\"element-citation\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003eCirillo N, Dell’Ermo A, Gombos F, Lanza A. The specific proteolysis hypothesis of pemphigus: Does the song remain the same? Medical hypotheses. 2008;70(2):333-7.\u003c\/span\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003c\/div\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman','serif'; mso-fareast-font-family: 'Times New Roman'; color: black; mso-themecolor: text1; mso-ansi-language: EN-US; mso-fareast-language: EN-US; mso-bidi-language: AR-SA;\"\u003e\u003cbr style=\"page-break-before: auto; mso-break-type: section-break;\" clear=\"all\"\u003e\u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1; mso-bidi-font-weight: bold;\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"mso-pagination: none; mso-layout-grid-align: none; text-autospace: none;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-family: 'Arial','sans-serif'; color: black; mso-themecolor: text1;\"\u003e \u003c\/span\u003e\u003c\/p\u003e\n\u003cp style=\"text-align: justify;\" class=\"MsoNormal\"\u003e\u003cspan style=\"font-size: 10.0pt; color: black; mso-themecolor: text1;\"\u003e \u003c\/span\u003e\u003c\/p\u003e","brand":"Skin Life \u0026 Aesthetic Clinic","offers":[{"title":"Default Title","offer_id":42394168918118,"sku":"","price":0.0,"currency_code":"PKR","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0618\/2885\/7958\/files\/Picture1_cac450a1-b36e-4e4a-8e04-0b3e881a3958.png?v=1735225500"}],"url":"https:\/\/www.skinlifeclinic.info\/collections\/blog.oembed","provider":"Skin Life Clinic","version":"1.0","type":"link"}