| Serologic and clinical response to treatment of systemic vasculitis and associated autoimmune disease with intravenous immunoglobulin. | |
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MedLine Citation:
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PMID: 10436395 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article |
Journal Detail:
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Title: International archives of allergy and immunology Volume: 119 ISSN: 1018-2438 ISO Abbreviation: Int. Arch. Allergy Immunol. Publication Date: 1999 Jul |
Date Detail:
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Created Date: 1999-09-02 Completed Date: 1999-09-02 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9211652 Medline TA: Int Arch Allergy Immunol Country: SWITZERLAND |
Other Details:
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Languages: eng Pagination: 231-8 Citation Subset: IM |
Affiliation:
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Department of Medicine 'B' and the Research Unit of Autoimmune Diseases, Tel-Hashomer, and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Autoantibodies; 0/Immunoglobulins, Intravenous |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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