Intravenous immunoglobulin treatment of lupus nephritis
| Autor: | Yehuda Shoenfeld, Yair Levy, Jozef Lukáč, Peter Poprac, Jozef Rovensky, Lubica Rauova, Jacob George, Yaniv Sherer, Fabrizio Fabbrizzi, Pnina Langevitz |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Nephrotic Syndrome Cyclophosphamide Adolescent Lupus nephritis Drug Resistance Kidney Function Tests Gastroenterology Nephropathy Rheumatology hemic and lymphatic diseases Internal medicine Membranoproliferative glomerulonephritis medicine Humans Proteinuria Lupus erythematosus business.industry Immunoglobulins Intravenous Middle Aged medicine.disease Lupus Nephritis Anesthesiology and Pain Medicine Treatment Outcome Immunology Mesangial proliferative glomerulonephritis Prednisone Female medicine.symptom business Nephrotic syndrome Biomarkers medicine.drug |
| Zdroj: | Seminars in arthritis and rheumatism. 29(5) |
| ISSN: | 0049-0172 |
| Popis: | Objective: To evaluate the clinical response of treatment-resistant membranousand membranoproliferative lupus nephritis to intravenous immunoglobulin (IVIg). Methods: Seven lupus nephritis patients who failed to respond to at leastprednisone and cyclophosphamide were studied. A kidney biopsy showing either membranous or membranoproliferative glomerulonephritis was available in six patients. They were treated with six courses (patients 1 and 2) or 1 or 2 courses (patients 3 through 7) of high-dose IVIg. For patients 3 through 7, the plasma levels of albumin, total cholesterol, urea, creatinine; dsDNA antibody titers, and daily proteinuria were measured just before the IVIg therapy, immediately on completion, and 6 months later. Results: All seven patients had a beneficial response to IVIg. In patient 1, decrease in proteinuria was evident 2 weeks after IVIg was started, nephrotic syndrome gradually disappeared, and she had no proteinuria in 3 years' follow-up. Decline in proteinuria was evident in patient 2 after the 4th IVIg course, but proteinuria reached the pretreatment level 4 months after the therapy ended. In patients 3 through 7, the mean daily proteinuria before IVIg (5.3 ± 2.1 g) decreased after 1 or 2 IVIg courses (3.3 ± 1.4 g), and further decreased when measured 6 months later (2.1 ± 1.3 g). Similarly, the plasma, cholesterol level decreased while the plasma albumin level increased after IVIg. Conclusions: IVIg might be effective in treatment-resistant membranous ormembranoproliferative lupus nephritis. Future studies should concentrate on determining the preferred treatment protocol of IVIg for the various classes of lupus nephritis. |
| Databáze: | OpenAIRE |
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