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Clinical Reviews in Allergy & Immunology

, Volume 29, Issue 3, pp 219–228 | Cite as

Intravenous immunoglobulin therapy and systemic lupus erythematosus

  • Gisele Zandman-Goddard
  • Yair Levy
  • Yehuda ShoenfeldEmail author
Article

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.

Index Entries

SLE IVIg lupus immunoglobulins 

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Copyright information

© Humana Press Inc 2005

Authors and Affiliations

  • Gisele Zandman-Goddard
    • 1
    • 2
  • Yair Levy
    • 3
    • 4
  • Yehuda Shoenfeld
    • 1
    • 5
    Email author
  1. 1.Center for Autoimmune Diseases and Department of Medicine BTel AvivIsrael
  2. 2.Lupus Clinic, Sheba Medical CenterTel AvivIsrael
  3. 3.Department of MedicineMeir HospitalTel AvivIsrael
  4. 4.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  5. 5.Incumbent of Laura Schwarz-Kipp, Chair of AutoimmunityTel Aviv UniversityTel AvivIsrael

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