Intravenous immunoglobulin therapy and systemic lupus erythematosus

Gisele Zandman-Goddard, Yair Levy, Yehuda Shoenfeld

Research output: Contribution to journalArticlepeer-review

Abstract

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease with diverse manifestations. We suggest that intravenous immunoglobulin (IVIg) therapy may be beneficial and safe for various manifestations in SLE. A structured literature search of articles published on the efficacy of IVIg in the treatment of SLE between 1983 and 2005 was conducted. We searched the terms "IVIg," "intravenous immunoglobulin," "lupus," "SLE," and "systemic lupus erythematosus." The various clinical manifestations of SLE that were reported to be successfully treated by IVIg in case reports include autoimmune hemolytic anemia, acquired factor VIII inhibitors, acquired von Willebrand disease, pure red cell aplasia, thrombocytopenia, pancytopenia, myelofibrosis, pneumonitis, pleural effusion, pericarditis, myocarditis, cardiogenic shock, nephritis, end-stage renal disease, encephalitis, neuropsychiatric lupus, psychosis, peripheral neuropathy, polyradiculoneuropathy, and vasculitis. The most extensive experience is with lupus nephritis. There are only a few case series of IVIg use in patients with SLE with various manifestations, in which the response rate to IVIg therapy ranged from 33 to 100%. We suggest that IVIg devoid of sucrose, at a dose of 2 g/kg over a 5-d period given uniformly and at a slow infusion rate in patients without an increased risk for thromboembolic events or renal failure, is a safe and beneficial adjunct therapy for cases of SLE that are resistant to or refuse conventional treatment. The duration of therapy is yet to be established. Controlled trials are warranted.

Original languageEnglish
Pages (from-to)219-228
Number of pages10
JournalClinical Reviews in Allergy and Immunology
Volume29
Issue number3
DOIs
StatePublished - Dec 2005

Keywords

  • IVIg
  • Immunoglobulins
  • Lupus
  • SLE

Fingerprint

Dive into the research topics of 'Intravenous immunoglobulin therapy and systemic lupus erythematosus'. Together they form a unique fingerprint.

Cite this