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Intravenous immunoglobulin therapy and systemic lupus erythematosus

Clinical Reviews in Allergy & Immunology volume 29, pages 219–228 (2005)Cite this 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.

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Author information

Affiliations

  1. Center for Autoimmune Diseases and Department of Medicine B, Tel Aviv, Israel

    Gisele Zandman-Goddard & Yehuda Shoenfeld

  2. Lupus Clinic, Sheba Medical Center, Tel Aviv, Israel

    Gisele Zandman-Goddard

  3. Department of Medicine, Meir Hospital, Tel Aviv, Israel

    Yair Levy

  4. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Yair Levy

  5. Incumbent of Laura Schwarz-Kipp, Chair of Autoimmunity, Tel Aviv University, Tel Aviv, Israel

    Yehuda Shoenfeld

Authors
  1. Gisele Zandman-Goddard
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  2. Yair Levy
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  3. Yehuda Shoenfeld
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Corresponding author

Correspondence to Yehuda Shoenfeld.

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Zandman-Goddard, G., Levy, Y. & Shoenfeld, Y. Intravenous immunoglobulin therapy and systemic lupus erythematosus. Clinic Rev Allerg Immunol 29, 219–228 (2005). https://doi.org/10.1385/CRIAI:29:3:219

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  • DOI: https://doi.org/10.1385/CRIAI:29:3:219

Index Entries

  • SLE
  • IVIg
  • lupus
  • immunoglobulins