Document Detail


Serologic and clinical response to treatment of systemic vasculitis and associated autoimmune disease with intravenous immunoglobulin.
MedLine Citation:
PMID:  10436395     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Autoimmune vasculitides cannot always be controlled by steroids and immunosuppressive drugs. Intravenous immunoglobulin (IVIg) treatment was found beneficial in several vasculitides including systemic and organ-specific diseases. In this article we tested whether the beneficial clinical response of IVIg treatment in vasculitides was accompanied by a decrease in vasculitis-associated autoantibody levels. METHODS: Ten patients diagnosed as having vasculitis were treated with high-dose (2 g/kg) IVIg monthly, in a 5-day schedule. In all the patients, other therapeutic measures failed to control disease progression prior to IVIg treatment. Each patient received between 1 and 6 treatment courses. All patients were evaluated for the levels of 5 autoantibodies (Abs) related to vasculitis before and after each treatment course. RESULTS: In 6 out of the 10 patients, a beneficial clinical response followed IVIg treatment. Moreover, no treatment-related adverse effects were observed in any of the patients. Anti-myeloperoxidase antibodies and cytoplasmic-antineutrophil cytoplasmic antibodies levels decreased concomitantly with the clinical improvement observed in the patients with Churg-Strauss vasculitis and Wegener's granulomatosis, respectively. Levels of cytoplasmic-antineutrophil cytoplasmic antibodies (ANCA) with specificity for bacteridial/permeability-increasing protein and human lysosomal-associated membrane protein increased after each treatment course, but returned to normal values before the following one. CONCLUSIONS: When other therapeutic measures, such as immunosuppressive therapy, fails to control disease manifestations in patients with vasculitides, IVIg is a possible effective intervention method with a high response rate. IVIg probably exerted its effects on disease progression via different mechanisms. Among these mechanisms, a decrease in relevant Ab levels is often found (probably by anti-idiotypes in IVIg), and thus ANCA levels are expected to associate with disease activity.
Authors:
Y Levy; Y Sherer; J George; P Langevitz; A Ahmed; Y Bar-Dayan; F Fabbrizzi; J Terryberry; J Peter; Y Shoenfeld
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International archives of allergy and immunology     Volume:  119     ISSN:  1018-2438     ISO Abbreviation:  Int. Arch. Allergy Immunol.     Publication Date:  1999 Jul 
Date Detail:
Created Date:  1999-09-02     Completed Date:  1999-09-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9211652     Medline TA:  Int Arch Allergy Immunol     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  231-8     Citation Subset:  IM    
Affiliation:
Department of Medicine 'B' and the Research Unit of Autoimmune Diseases, Tel-Hashomer, and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Autoantibodies / blood,  immunology
Autoimmune Diseases / drug therapy*,  immunology*,  physiopathology
Female
Humans
Immunoglobulins, Intravenous / administration & dosage*
Male
Middle Aged
Treatment Outcome
Vasculitis / drug therapy*,  immunology*,  physiopathology
Chemical
Reg. No./Substance:
0/Autoantibodies; 0/Immunoglobulins, Intravenous

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