AB0212 Experience with intravenous immunoglobulin therapy in twenty patients with different autoimmune rheumatic diseases. (1st June 2001) - Kamali, S
Abstract : Background: Objectives: Retrospective evaluation of high dose intravenous immunoglobulin (IVIG) treatment in patients with connective tissue diseases. Methods: We evaluated the records of 8 patients with systemic lupus erythematosus (SLE), 8 patients with inflammatory muscle disease [polimyositis (PM), juvenil dermatomyositis (JDM), dermatomyositis (DM)] and 4 patients with Wegener's granulomatosis (WG) who received 2 g/kg IVIG in 5 days 1–12 times monthly. Results: The indications of IVIG therapy were: severe thrombocytopenia with active disease despite corticosteroid and immunosuppressive therapy in 7 patients and concurrent mycobacterial infection in 2 patients with SLE; resistance to standard treatment in 7 patients with PM/DM and 3 patients with WG. Fifteen of 20 patients received concomitant high dose prednisolone, methotrexate, azathioprine and/or pulse cyclophosphamide therapy. In two patients, IVIG was used because of concomitant viral infections (one patient with DM+chronic active hepatitis due to Hepatitis B virus and 1 patient with WG+cytomegalovirus chorioretinitis) Two patients with DM died of underlying malignancies and 3 patients with SLE died of uncontrolled disease activity. No serious side effects related to IVIG therapy were observed. Conclusion: High dose IVIG is an effective and tolerable option when standard therapies are failed or a rapid response is needed in patients with PM/DM and WG. In SLE the main indication for IVIG is steroid resistant severe thrombocytopenia. IVIG therapy may also be preferable in patients with active disease and concurrent severe infections.