{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:04:40Z","timestamp":1784307880958,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Paraneoplastic pemphigus (PNP) is a life\u2010threatening autoimmune blistering disease with a mortality rate of 70%\u201390%, driven largely by respiratory complications such as bronchiolitis obliterans. Managing respiratory failure in these patients remains exceptionally difficult. We report a 33\u2010year\u2010old male with follicular dendritic cell sarcoma who developed severe PNP complicated by type II respiratory failure and obstructive bronchiolitis requiring veno\u2010venous extracorporeal membrane oxygenation (ECMO) support. The patient's PNP skin lesions improved during a treatment course that included ECMO support, intravenous immunoglobulin (IVIG), immunosuppressants, hemodialysis, and plasma exchange. Serial immune cell subset monitoring showed a rising CD4\/CD8 ratio (+94.8%) and Helper T cells (+33.8%), alongside declining NK cells (\u221248.2%), T lymphocytes (\u221217.7%), and Suppressor T cells (\u221231.6%). This case illustrates successful short\u2010term management of severe PNP with respiratory failure through multidisciplinary care, including ECMO. Because multiple interventions were administered concurrently, improvement cannot be attributed to any single therapy. Serial immune\u2010cell monitoring may help track treatment response in this setting.<\/jats:p>","DOI":"10.1002\/ccr3.72824","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:00:49Z","timestamp":1780632049000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["<scp>ECMO<\/scp>\n                    Support in Paraneoplastic Pemphigus With Respiratory Failure: A Case Report With Immune Cell Monitoring"],"prefix":"10.1002","volume":"14","author":[{"given":"Lu","family":"Li","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacy, Department of Pharmacy, the First Affiliated Hospital Zhejiang University School of Medicine  Hangzhou China"},{"name":"Department of Emergency Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danxia","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency, Shanghai Fourth People's Hospital Tongji University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linzi","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Emergency, Shanghai Fourth People's Hospital Tongji University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinqin","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Emergency, Shanghai Fourth People's Hospital Tongji University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"He","sequence":"additional","affiliation":[{"name":"Department of Emergency Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-2236-5199","authenticated-orcid":false,"given":"Yan","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Emergency, Shanghai Fourth People's Hospital Tongji University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"issue":"2","key":"e_1_2_15_2_1","first-page":"193","article-title":"Classification, clinical manifestations, and immunopathological mechanisms of the epithelial variant of paraneoplastic autoimmune multiorgan syndrome","volume":"137","author":"Nguyen V. T.","year":"2001","journal-title":"Archives of Dermatology"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.18931"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2025.15408"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1512156"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.15158"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2023.08.084"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejpb.2024.114261"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1363032"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.09.052"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-1742"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000002259"},{"issue":"12","key":"e_1_2_15_13_1","first-page":"1162","article-title":"Therapy of follicular lymphoma associated bronchiolitis obliterans with lung transplantation: 2 cases and literature review","volume":"48","author":"Cai Y.","year":"2025","journal-title":"Zhonghua Jie He He Hu Xi Za Zhi"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.14496"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2024.10.013"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anndiagpath.2025.152602"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2026.1799535"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72824","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.72824","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72824","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T16:21:37Z","timestamp":1784305297000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.72824"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":16,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/ccr3.72824"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.72824","archive":["Portico"],"relation":{"has-preprint":[{"id-type":"doi","id":"10.22541\/au.175983188.88833068\/v1","asserted-by":"object"}]},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2025-09-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72824"}}