Rare Disease Diagnosis: The Journey of a 19-Year-Old Male Student Recovering from Paraneoplastic Pemphigus

A 19-year-old male student from Thanh Hoa, Vietnam was diagnosed with Pemphigus spondylitis, a rare disease that had not been previously recorded in Vietnamese medical literature. The patient began experiencing erosive ulcers on the oral mucosa and purple-red patches and scalds on his body in November of the previous year. After being initially examined at a local hospital, he was transferred to the Central Dermatology Hospital and then to Bach Mai Hospital for further treatment.

Following a skin biopsy, the patient was diagnosed with toxic epidermal necrolysis in January of 2024. Subsequently, he was also diagnosed with paraneoplastic pemphigus, bilateral ureteral stones, and a weakened physical condition. Despite being scheduled for surgery, his weakened state forced him to be discharged from the hospital for nutritional supplementation. However, he experienced new outbreaks of symptoms in April, leading to more treatment including plasma replacement and antibiotics.

Throughout the treatment process, medical professionals faced challenges due to the patient’s inconsistent symptoms and histopathological results. Despite the difficulties, the doctors continuously consulted and researched to provide the most accurate diagnosis and care. The patient’s poor response to conventional immunotherapy, along with other complications, made the treatment process even more challenging. However, with the efforts of the medical team and the support of the patient’s family, he was able to overcome the illness and recover.

The successful treatment and recovery of this young student serve as a testament to the dedication and expertise of medical professionals involved in his case. Paraneoplastic pemphigus is a rare disease typically associated with lymphoproliferative disorders and is more common in older individuals.

The patient was covered by health insurance for most of his treatment costs; however, his family contributed a smaller amount towards it.

In conclusion, this case highlights how complex some diseases can be when they are not well understood or have not been previously recorded in medical literature. Medical professionals must be persistent in their efforts to diagnose such cases accurately while providing effective care for patients like this one who may face multiple complications during their journey towards recovery.