Use of intravenous humana immunoglobulin in rheumatic diseases

Authors

  • Eduardo D. Mussano Servicio de Reumatologia, UHMI 1, Hospital Nacional de Clínicas. Facultad de Ciencias Médicas, Universidad Nacional de Córdoba Santa Rosa.
  • Laura B. Onetti Servicio de Reumatologia, UHMI 1, Hospital Nacional de Clínicas. Facultad de Ciencias Médicas, Universidad Nacional de Córdoba Santa Rosa.
  • Isaac I. Cadile Servicio de Reumatologia, UHMI 1, Hospital Nacional de Clínicas. Facultad de Ciencias Médicas, Universidad Nacional de Córdoba Santa Rosa.
  • Carlos M. Onetti Servicio de Reumatologia, UHMI 1, Hospital Nacional de Clínicas. Facultad de Ciencias Médicas, Universidad Nacional de Córdoba Santa Rosa.

DOI:

https://doi.org/10.31053/1853.0605.v69.n2.21339

Keywords:

intravenous immunoglobulin, rheumatic diseases, therapeutic efficacy

Abstract


Introduction
: Preparations of intravenous immunoglobulin (IVIG) are used as treatment in different diseases such primary and secondary immunodeficiencies, autoimmune diseases, systemic inflammatory diseases, infectious diseases and allergic diseases among others.

Objective: to present 13 of our cases with the use of IVIG in different rheumatic diseases.
Patients and methods: we retrospectively studied 13 patients (10 women and 3 men), mean age 29 years with different rheumatic diseases, that underwent conventional treatments without positive response. They received IVIG pulses, trying to improve or induce remission of their previous clinical situation. 6/13 patients met criteria for systemic lupus erythematosus (SLE), 2/13 had primary antiphospholipid syndrome (APL)one had polydermatomyositis (PDM), 1 juvenile arthritis, 1 panarteritis nodosa (cutaneous PAN), one Evans syndrome, and one with autoimmune uveitis.

Results: 7 of them had a positive response to therapy with IGEV evaluated by clinical and biochemical parameters. They remained with conventional treatments. One patient received a new IG EV pulse after 24 months, because of panniculitis reactivation. Clinical and biochemical response was poor in 4 of them, and 2 patients died.

Conclusion: IVIg may be usefull in autoimmune rheumatic diseases when conventional therapies have failed. The therapeutic success is also limited. Only the 55 percent of our patients had a positive clinical response.

Downloads

Download data is not yet available.

References

Danieli MG, Calcabrini L, Marchetti A, Calabrese V, Pettinari L, Massaccesi C, Gabrielli A, Danieli G. Intravenous immunoglobulin treatment in autoimmune diseases. Recenti Prog Med. 2007; 98(6):322-6.

Nydegger U. Old and current aspects of intravenous immunoglobulin therapy. Schweiz Med Wochenschr: 1994 Jan 11;124(1-2):5-25.

Sisti A, Manfredi MJ: Inmunoglobulina G Endovenosa: Mecanismos de acción e indicaciones clínicas. Alerg Inmunol Clin: 2000. 17(4) 168-175.

Sisti A, Vitali MS, Zarzur J, Ma fredi MJ. Inmunoglobulina G Endovenosa; características de un medicamento elaborado en la Argentina. Arch Arg. Alergia Inmunol. Clínica: 2000; 31:4:115-124.

Rewald E, Suringar F. Tolerance of Intravenous Gamma Globulin. Proc. 11 th Congress Int. Soc. Blood Transf. Sydney 1966.Bibl Haematol Karger, Basel/New York, 1968, p 33-9.

Imbach P, Wargner HP, Berthold W et al. Intavenous immunoglobulin versus oral corticosteroids in acute immune thrombocytopenic purpura in childhood. Lancet: 1985; 2:464-8.

Sherer Y, Levy Y, Fabbrizzi F, Shoenfeld Y. Treatment of hematologic disorders other than immune thrombocytopenic purpura with intravenous immunoglobulin (IVIg) - report of seven cases and review of the literature.Eur J Intern Med: 2000 Apr ; 11(2):85-88.

Go RS, Johnston KL, Bruden KC. The association between platelet autoantibody specificity and response to intravenous immunoglobulin G in the treatment of patients with immune thrombocytopenia.Haematologica: 2007 Feb; 92(2):283-4.

Newburger JW, Takahashi M, Bums JC, et al. The treatment of Kawasaki syndrome with intravenous gamma globulin. N Engl J Med: 1986; 315: 341-347.

Sherer Y, Kuechler S, Jose Scali J, Rovensky J, Levy Y, Zandman-Goddard G, Shoenfeld Y. Low dose intravenous immunoglobulin in systemic lupus erythematosus: analysis of 62 cases. Isr Med Assoc J: 2008 Jan;10 (1):55-7.

Levy Y, Sherer Y, Ahmed A, Langevitz P, George J, Fabrizzi F, Terryberry J, Meissner M, Lorber M, Peter JB, Schoenfeld Y. A study of 20 patients with intravenous immunoglobulin-clinical and serologic response. Lupus: 1999; 8(9):705-12.

Sherer Y, Shoenfeld Y. Intravenous immunoglobulin for immunomodulation of systemic lupus erythematosus.Autoimmun Rev: 2006 Feb; 5(2):153-5.

Winder A, Molad Y, Ostfeld I, et al: Treatment of systemic lupus erithematosus by prolonged administration of high dose intravenous immunoglobulin: report of two cases. J Rheumatol: 1993; 20: 795.

Espírito Santo J, Gomes MF, Gomes MJ, Peixoto L, C Pereira S, Acabado A, Freitas J, de Sousa GV. Intravenous Immunoglobulin in Lupus Panniculitis. Clin Rev Allergy Immunol. 2009 Jun 27.

Lampropoulos CE, Hughes GR, D' Cruz DP. Intravenous immunoglobulin in the treatment of resistant subacute cutaneous lupus erythematosus: a possible alternative.Clin Rheumatol. 2007 Jun;26 (6):981-3.

Goodfield M, Davison K, Bowden K. Intravenous immunoglobulin (IVIg) for therapy-resistant cutaneous lupus erythematosus (LE).J Dermatolog Treat. 2004 Jan;15(1):46-50.

Asano Y, Ihn H, Maekawa T, Kadono T, Tamaki K. High-dose intravenous immunoglobulin infusion in polyarteritis nodosa: report on one case and review of the literature. Clin Rheumatol. 2006 May;25 (3):396-8.

Martinez V, Cohen P, Pagnoux C, Vinzio S, Mahr A, Mouthon L, Sailler L, Delaunay C, Sadoun A, Guillevin L; French Vasculitis Study Group. Intravenous immunoglobulins for relapses of systemic vasculitides associated with antineutrophil cytoplasmic autoantibodies: results of a multicenter, prospective, open-label study of twenty-two patients. Arthritis Rheum 2008 Jan; 58 (1):308-1.

Krause I, et al. Abrogation of experimental sistemic lupus erythematosus and primaria antiphospholipid syndrome with intravenous gammaglobulin. J Rheumatol. 1995; 22:1068-7.

Bakimir R, Guilburd B, Zurgil N, Schoenfeld Y. The effect of intravenous gammaglobulin on the induction of experimental antiphospholipid syndrome. Clin. Inmunol. Inmunopathol 1993; 69:97-102.

Bianco D, Hardy RM. Treatment of Evans' syndrome with human intravenous immunoglobulin and leflunomide in a diabetic dog.J Am Anim Hosp Assoc. 2009 May-Jun;45 (3):147-50.

Bolis S, Marozzi A, Rossini F, Casaroli I, Pogliani EM, Corneo G. High dose intravenous immunoglobulin (IVIgG) in Evans' syndrome. Allergol Immunopathol (Madr). 1991 Sep-Oct; 19 (5):18.

Sha?kov AV, Kuznetsova IO, Movsisian GR. Intravenous immunoglobulin in combined therapy for children with juvenile rheumatoid arthritis (evaluation of therapeutical efficiency and factors that influence them) Vestn Ross Akad Med Nauk. 1998; (12):36-9.

Giannini EH, Lovell DJ, Silverman ED, Sundel RP, Tague BL, Ruperto N. Intravenous immunoglobulin in the treatment of polyarticular juvenile rheumatoid arthritis: a phase I/II study. Pediatric Rheumatology Collaborative Study Group.J Rheumatol. 1996 May;23 (5):919-24.

Uziel Y, Laxer RM, Schneider R, Silverman ED. Intravenous immunoglobulin therapy in systemic onset juvenile rheumatoid arthritis: a followup study.J Rheumatol. 1996 May;23 (5):910-8.

Silverman ED, Cawkwell GD, Lovell DJ, Laxer RM, Lehman TJ, Passo MH, Zemel LS, Giannini EH. Intravenous immunoglobulin in the treatment of systemic juvenile rheumatoid arthritis: a randomized placebo controlled trial. Pediatric Rheumatology Collaborative Study Group.

Danieli MG, Calcabrini L, Calabrese V, Marchetti A, Logullo F, Gabrielli A.Intravenous immunoglobulin as add on treatment with mycophenolate mofetil in severe myositis. Autoimmun Rev. 2009 Apr 19.

Barbasso Helmers S, Dastmalchi M, Alexanderson H, Nennesmo I, Esbjörnsson M, Lindvall B, Lundberg IE.. Limited effects of high-dose intravenous immunoglobulin (IVIG) treatment on molecular expression in muscle tissue of patients with inflammatory myopathies Ann Rheum Dis. 2007 Oct;66 (10):1276-83.

Williams L, Chang PY, Park E, Gorson KC, Bayer-Zwirello L. Successful treatment of dermatomyositis during pregnancy with intravenous immunoglobulin monotherapy.Obstet Gynecol. 2007 Feb;109:561-3.

Pras E, Neumann R, Zandman-Goddard G, Levy Y, Assia EI, Shoenfeld Y, Langevitz P. Intraocular inflammation in autoimmune diseases. Semin Arthritis Rheum. 2004 Dec;34(3):602-9.

Published

2018-09-17

Issue

Section

Original Papers

How to Cite

1.
Mussano ED, Onetti LB, Cadile II, Onetti CM. Use of intravenous humana immunoglobulin in rheumatic diseases. Rev Fac Cien Med Univ Nac Cordoba [Internet]. 2018 Sep. 17 [cited 2024 Dec. 28];69(2):83-9. Available from: https://revistas.unc.edu.ar/index.php/med/article/view/21339

Similar Articles

1-10 of 590

You may also start an advanced similarity search for this article.