Intravenous immunoglobulin for corticosteroid-resistant intestinal Henoch-Schönlein purpura: worth a controlled trial against corticosteroids?
| Autor: | Francesco Morotti, Lorella Cattaneo, Enrico Felici, Giulia Bracciolini, Angelo Ravelli, Marco Gattorno, Roberta Caorsi |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Henoch-Schonlein purpura Adolescent IgA Vasculitis medicine.drug_class Drug Resistance Immunoglobulins Disease law.invention paediatric rheumatology 03 medical and health sciences 0302 clinical medicine Rheumatology Randomized controlled trial Refractory law 030225 pediatrics medicine Humans Immunologic Factors Pharmacology (medical) Child Preschool Glucocorticoids 030203 arthritis & rheumatology IVIG research biology treatment business.industry intestinal vasculitis Immunoglobulins Intravenous medicine.disease Purpura Intestinal Diseases Child Preschool biology.protein Corticosteroid Controlled Clinical Trials as Topic medicine.symptom Antibody business Vasculitis Intravenous |
| Zdroj: | Rheumatology (Oxford, England). 60(8) |
| ISSN: | 1462-0332 |
| Popis: | Objectives Henoch–Schönlein purpura (HScP) may present in children with severe, occasionally refractory, gastrointestinal (GI) involvement. The use of corticosteroids (CSs) is commonplace in the management of the disease, but to date no standardized protocol is available and, although rare, resistance to CS therapy may be challenging to clinicians. IVIG has been proposed as an effective alternative to CSs, but to date no controlled trial has been conducted to ascertain their real efficacy. We share our personal experience of successful IVIG treatment in two cases of GI HScP, comparing it with similar experiences reported in literature. Methods Retrospective clinical data collection, comparison with available literature. Results We describe two children with severe HScP GI vasculitis refractory to high-dose intravenous CSs that responded rapidly to IVIG administration, with complete recovery within a few days. Patient characteristics and response to IVIG administration were comparable to those of other previously reported cases. Conclusion Our observation confirms that IVIG may be useful in the treatment of CS-resistant HScP-related GI vasculitis in children, and highlights the need for more structured research, including a randomized trial against CSs, in order to ascertain their real effectiveness. |
| Databáze: | OpenAIRE |
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