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Pemphigus Vulgaris; Duodenal Ulcer; Osteoporosis of Lumbosacral Vertebrae; Bronchial Asthma. Presented by Dr. Jesse A. Tolmach for Dr. Thelma G. Warshaw.
History: A 67-year-old woman was admitted to Beth Israel Hospital on Nov. 8, 1955, with an 18-year history of bronchial asthma and a 2½-year history of pemphigus vulgaris. She was treated with cortisone and ACTH, and a clinical remission followed. Eight months ago, steroids were stopped, and there was a relapse. Steroid treatment was reinstituted, and remission again resulted.
Two months before admission the patient developed low-back pain that radiated bilaterally, persistent epigastric pain, and a productive cough.
Dr. Beatrice Kesten: We have the tiger by the tail. We improve the pemphigus, change the patient, and produce other diseases. One can expect 10% to 15% to develop osteoporosis and peptic ulcer while on prolonged corticosteroid therapy, regardless of which ones are given. The current theory on